WorldWideScience

Sample records for exploration medical capability

  1. Exploration Medical Capability - Technology Watch

    Science.gov (United States)

    Krihak, Michael; Watkins, Sharmila; Barr, Yael; Barsten, Kristina; Fung, Paul; Baumann, David

    2011-01-01

    The objectives of the Technology Watch process are to identify emerging, high-impact technologies that augment current ExMC development efforts, and to work with academia, industry, and other government agencies to accelerate the development of medical care and research capabilities for the mitigation of potential health issues that could occur during space exploration missions. The establishment of collaborations with these entities is beneficial to technology development, assessment and/or insertion. Such collaborations also further NASA s goal to provide a safe and healthy environment for human exploration. The Tech Watch project addresses requirements and capabilities identified by knowledge and technology gaps that are derived from a discrete set of medical conditions that are most likely to occur on exploration missions. These gaps are addressed through technology readiness level assessments, market surveys, collaborations and distributed innovation opportunities. Ultimately, these gaps need to be closed with respect to exploration missions, and may be achieved through technology development projects. Information management is a key aspect to this process where Tech Watch related meetings, research articles, collaborations and partnerships are tracked by the HRP s Exploration Medical Capabilities (ExMC) Element. In 2011, ExMC will be introducing the Tech Watch external website and evidence wiki that will provide access to ExMC technology and knowledge gaps, technology needs and requirements documents.

  2. Exploration Medical Capability (ExMC) Projects

    Science.gov (United States)

    Wu, Jimmy; Watkins, Sharmila; Baumann, David

    2010-01-01

    During missions to the Moon or Mars, the crew will need medical capabilities to diagnose and treat disease as well as for maintaining their health. The Exploration Medical Capability Element develops medical technologies, medical informatics, and clinical capabilities for different levels of care during space missions. The work done by team members in this Element is leading edge technology, procedure, and pharmacological development. They develop data systems that protect patient's private medical information, aid in the diagnosis of medical conditions, and act as a repository of relevant NASA life sciences experimental studies. To minimize the medical risks to crew health the physicians and scientists in this Element develop models to quantify the probability of medical events occurring during a mission. They define procedures to treat an ill or injured crew member who does not have access to an emergency room and who must be cared for in a microgravity environment where both liquids and solids behave differently than on Earth. To support the development of these medical capabilities, the Element manages the development of medical technologies that prevent, monitor, diagnose, and treat an ill or injured crewmember. The Exploration Medical Capability Element collaborates with the National Space Biomedical Research Institute (NSBRI), the Department of Defense, other Government-funded agencies, academic institutions, and industry.

  3. Systems Engineering for Space Exploration Medical Capabilities

    Science.gov (United States)

    Mindock, Jennifer; Reilly, Jeffrey; Rubin, David; Urbina, Michelle; Hailey, Melinda; Hanson, Andrea; Burba, Tyler; McGuire, Kerry; Cerro, Jeffrey; Middour, Chris; hide

    2017-01-01

    Human exploration missions that reach destinations beyond low Earth orbit, such as Mars, will present significant new challenges to crew health management. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its goals. This paper discusses the structured and integrative approach that is guiding the medical system technical development. Assumptions for the required levels of care on exploration missions, medical system goals, and a Concept of Operations are early products that capture and clarify stakeholder expectations. Model-Based Systems Engineering techniques are then applied to define medical system behavior and architecture. Interfaces to other flight and ground systems, and within the medical system are identified and defined. Initial requirements and traceability are established, which sets the stage for identification of future technology development needs. An early approach for verification and validation, taking advantage of terrestrial and near-Earth exploration system analogs, is also defined to further guide system planning and development.

  4. Defining Medical Capabilities for Exploration Missions

    Science.gov (United States)

    Hailey, M.; Antonsen, E.; Blue, R.; Reyes, D.; Mulcahy, R.; Kerstman, E.; Bayuse, T.

    2018-01-01

    Exploration-class missions to the moon, Mars and beyond will require a significant change in medical capability from today's low earth orbit centric paradigm. Significant increases in autonomy will be required due to differences in duration, distance and orbital mechanics. Aerospace medicine and systems engineering teams are working together within ExMC to meet these challenges. Identifying exploration medical system needs requires accounting for planned and unplanned medical care as defined in the concept of operations. In 2017, the ExMC Clinicians group identified medical capabilities to feed into the Systems Engineering process, including: determining what and how to address planned and preventive medical care; defining an Accepted Medical Condition List (AMCL) of conditions that may occur and a subset of those that can be treated effectively within the exploration environment; and listing the medical capabilities needed to treat those conditions in the AMCL. This presentation will discuss the team's approach to addressing these issues, as well as how the outputs of the clinical process impact the systems engineering effort.

  5. Human Research Program (HRP) Exploration Medical Capability (ExMC) Standing Review Panel (SRP)

    Science.gov (United States)

    Cintron, Nitza; Dutson, Eric; Friedl, Karl; Hyman, William; Jemison, Mae; Klonoff, David

    2009-01-01

    The SRP believes strongly that regularly performed in-flight crew assessments are needed in order to identify a change in health status before a medical condition becomes clinically apparent. It is this early recognition in change that constitutes the foundation of the "occupational health model" expounded in the HRP Requirements Document as a key component of the HRP risk mitigation strategy that will enable its objective of "prevention and mitigation of human health and performance risks". A regular crew status examination of physiological and clinical performance is needed. This can be accomplished through instrumented monitoring of routine embedded tasks. The SRP recommends addition of a new gap to address this action under Category 3.0 Mitigate the Risk. This new gap is closely associated with Task 4.19 which addresses the lack of adequate biomedical monitoring capabilities for performing periodic clinical status evaluations and contingency medical monitoring. A corollary to these gaps is the critical emphasis on preventive medicine, not only during pre- and post-flight phases of a mission as is the current practice, but continued into the in-flight phases of exploration class missions.

  6. Medical Simulations for Exploration Medicine

    Science.gov (United States)

    Reyes, David; Suresh, Rahul; Pavela, James; Urbina, Michelle; Mindock, Jennifer; Antonsen, Erik

    2018-01-01

    Medical simulation is a useful tool that can be used to train personnel, develop medical processes, and assist cross-disciplinary communication. Medical simulations have been used in the past at NASA for these purposes, however they are usually created ad hoc. A stepwise approach to scenario development has not previously been used. The NASA Exploration Medical Capability (ExMC) created a medical scenario development tool to test medical procedures, technologies, concepts of operation and for use in systems engineering (SE) processes.

  7. Graphical Visualization of Human Exploration Capabilities

    Science.gov (United States)

    Rodgers, Erica M.; Williams-Byrd, Julie; Arney, Dale C.; Simon, Matthew A.; Williams, Phillip A.; Barsoum, Christopher; Cowan, Tyler; Larman, Kevin T.; Hay, Jason; Burg, Alex

    2016-01-01

    NASA's pioneering space strategy will require advanced capabilities to expand the boundaries of human exploration on the Journey to Mars (J2M). The Evolvable Mars Campaign (EMC) architecture serves as a framework to identify critical capabilities that need to be developed and tested in order to enable a range of human exploration destinations and missions. Agency-wide System Maturation Teams (SMT) are responsible for the maturation of these critical exploration capabilities and help formulate, guide and resolve performance gaps associated with the EMC-identified capabilities. Systems Capability Organization Reporting Engine boards (SCOREboards) were developed to integrate the SMT data sets into cohesive human exploration capability stories that can be used to promote dialog and communicate NASA's exploration investments. Each SCOREboard provides a graphical visualization of SMT capability development needs that enable exploration missions, and presents a comprehensive overview of data that outlines a roadmap of system maturation needs critical for the J2M. SCOREboards are generated by a computer program that extracts data from a main repository, sorts the data based on a tiered data reduction structure, and then plots the data according to specified user inputs. The ability to sort and plot varying data categories provides the flexibility to present specific SCOREboard capability roadmaps based on customer requests. This paper presents the development of the SCOREboard computer program and shows multiple complementary, yet different datasets through a unified format designed to facilitate comparison between datasets. Example SCOREboard capability roadmaps are presented followed by a discussion of how the roadmaps are used to: 1) communicate capability developments and readiness of systems for future missions, and 2) influence the definition of NASA's human exploration investment portfolio through capability-driven processes. The paper concludes with a description

  8. Exploration Medical System Demonstration

    Science.gov (United States)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

  9. Exploration Medical Cap Ability System Engineering Overview

    Science.gov (United States)

    McGuire, K.; Mindock, J.

    2018-01-01

    Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and

  10. Conceptual Drivers for an Exploration Medical System

    Science.gov (United States)

    Antonsen, Erik; Hanson, Andrea; Shah, Ronak; Reed, Rebekah; Canga, Michael

    2016-01-01

    Interplanetary spaceflight, such as NASA's proposed three-year mission to Mars, provides unique and novel challenges when compared with human spaceflight to date. Extended distance and multi-year missions introduce new elements of operational complexity and additional risk. These elements include: inability to resupply medications and consumables, inability to evacuate injured or ill crew, uncharted psychosocial conditions, and communication delays that create a requirement for some level of autonomous medical capability. Because of these unique challenges, the approaches used in prior programs have limited application to a Mars mission. On a Mars mission, resource limitations will significantly constrain available medical capabilities, and require a paradigm shift in the approach to medical system design and risk mitigation for crew health. To respond to this need for a new paradigm, the Exploration Medical Capability (ExMC) Element is assessing each Mars mission phase-transit, surface stay, rendezvous, extravehicular activity, and return-to identify and prioritize medical needs for the journey beyond low Earth orbit (LEO). ExMC is addressing both planned medical operations, and unplanned contingency medical operations that meld clinical needs and research needs into a single system. This assessment is being used to derive a gap analysis and studies to support meaningful medical capabilities trades. These trades, in turn, allow the exploration medical system design to proceed from both a mission centric and ethics-based approach, and to manage the risks associated with the medical limitations inherent in an exploration class mission. This paper outlines the conceptual drivers used to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this paradigm. Keywords: (Max 6 keywords: exploration, medicine, spaceflight, Mars, research, NASA)

  11. Organizational Strategic Learning Capability: Exploring the Dimensions

    Science.gov (United States)

    Moon, Hanna; Sejong, Wendy; Valentine, Tom

    2017-01-01

    Purpose: How to build and enhance the strategic learning capability (SLC) of an organization becomes crucial to both research and practice. This study was designed with the purpose to conceptualize SLC by translating and interpreting the related literature to develop empirical dimensions that could be tested and used in a survey instrument.…

  12. The Royal Naval Medical Services: delivering medical operational capability. the 'black art' of Medical Operational Planning.

    Science.gov (United States)

    Faye, M

    2013-01-01

    This article looks to dispel the mysteries of the 'black art' of Medical Operational Planning whilst giving an overview of activity within the Medical Operational Capability area of Medical Division (Med Div) within Navy Command Headquarters (NCHQ) during a period when the Royal Naval Medical Services (RNMS) have been preparing and reconfiguring medical capability for the future contingent battle spaces. The rolling exercise program has been used to illustrate the ongoing preparations taken by the Medical Operational Capability (Med Op Cap) and the Medical Force Elements to deliver medical capability in the littoral and maritime environments.

  13. Exploring medical identity theft.

    Science.gov (United States)

    Mancilla, Desla; Moczygemba, Jackie

    2009-09-16

    The crime of medical identity theft is a growing concern in healthcare institutions. A mixed-method study design including a two-stage electronic survey, telephone survey follow-up, and on-site observations was used to evaluate current practices in admitting and registration departments to reduce the occurrence of medical identity theft. Survey participants were chief compliance officers in acute healthcare organizations and members of the Health Care Compliance Association. Study results indicate variance in whether or how patient identity is confirmed in healthcare settings. The findings of this study suggest that information systems need to be designed for more efficient identity management. Admitting and registration staff must be trained, and compliance with medical identity theft policies and procedures must be monitored. Finally, biometric identity management solutions should be considered for stronger patient identification verification.

  14. The Space Medicine Exploration Medical Condition List

    Science.gov (United States)

    Watkins, Sharmi; Barr, Yael; Kerstman, Eric

    2011-01-01

    Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC's goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this risk. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to define the set of medical conditions that are most likely to occur during exploration space flight missions. The list was derived from the International Space Station Medical Checklist, the Shuttle Medical Checklist, in-flight occurrence data from the Lifetime Surveillance of Astronaut Health, and NASA subject matter experts. The list of conditions was further prioritized for eight specific design reference missions with the assistance of the ExMC Advisory Group. The purpose of the SMEMCL is to serve as an evidence-based foundation for the conditions that could affect a crewmember during flight. This information is used to ensure that the appropriate medical capabilities are available for exploration missions.

  15. Capabilities of a FOXSI Small Explorer

    Science.gov (United States)

    Inglis, A. R.; Christe, S.; Glesener, L.; Krucker, S.; Dennis, B. R.; Shih, A.; Wilson-Hodge, C.; Gubarev, M.; Hudson, H. S.; Kontar, E.; Buitrago Casas, J. C.; Drake, J. F.; Caspi, A.; Holman, G.; Allred, J. C.; Ryan, D.; Alaoui, M.; White, S. M.; Saint-Hilaire, P.; Klimchuk, J. A.; Hannah, I. G.; Antiochos, S. K.; Grefenstette, B.; Ramsey, B.; Jeffrey, N. L. S.; Reep, J. W.; Schwartz, R. A.; Ireland, J.

    2015-12-01

    We present the FOXSI (Focusing Optics X-ray Solar Imager) small explorer (SMEX) concept, a mission dedicated to studying particle acceleration and energy release on the Sun. FOXSI is designed as a 3-axis stabilized spacecraft in low-Earth orbit making use of state-of-the-art grazing incidence focusing optics, allowing for direct imaging of solar X-rays. The current design being studied features three telescope modules deployed in a low-inclination low-earth orbit (LEO). With a 15 meter focal length enabled by a deployable boom, FOXSI will observe the Sun in the 3-50 keV energe range. The FOXSI imaging concept has already been tested on two sounding rocket flights, in 2012 and 2014 and on the HEROES balloon payload flight in 2013. FOXSI will image the Sun with an angular resolution of 5'', a spectral resolution of 0.5 keV, and sub-second temporal resolution using CdTe detectors. In this presentation we investigate the science objectives and targets which can be accessed from this mission. Because of the defining characteristic of FOXSI is true imaging spectroscopy with high dynamic range and sensitivity, a brand-new perspective on energy release on the Sun is possible. Some of the science targets discussed here include; flare particle acceleration processes, electron beams, return currents, sources of solar energetic particles (SEPs), as well as understanding X-ray emission from active region structures and the quiescent corona.

  16. Exploration Medical System Trade Study Tools Overview

    Science.gov (United States)

    Mindock, J.; Myers, J.; Latorella, K.; Cerro, J.; Hanson, A.; Hailey, M.; Middour, C.

    2018-01-01

    ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

  17. Exploration Medical System Demonstration Project

    Science.gov (United States)

    Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

    2011-01-01

    A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

  18. Exploration Medical System Demonstration (EMSD) Project

    Science.gov (United States)

    Chin, Duane

    2012-01-01

    The Exploration Medical System Demonstration (EMSD) is a project under the Exploration Medical Capability (ExMC) element managed by the Human Research Program (HRP). The vision for the EMSD is to utilize ISS as a test bed to show that several medical technologies needed for an exploration mission and medical informatics tools for managing evidence and decision making can be integrated into a single system and used by the on-orbit crew in an efficient and meaningful manner. Objectives: a) Reduce and even possibly eliminate the time required for on-orbit crew and ground personnel (which include Surgeon, Biomedical Engineer (BME) Flight Controller, and Medical Operations Data Specialist) to access and move medical data from one application to another. b) Demonstrate that the on-orbit crew has the ability to access medical data/information using an intuitive and crew-friendly software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management framework and architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities.

  19. Exploration Medical System Technical Architecture Overview

    Science.gov (United States)

    Cerro, J.; Rubin, D.; Mindock, J.; Middour, C.; McGuire, K.; Hanson, A.; Reilly, J.; Burba, T.; Urbina, M.

    2018-01-01

    The Exploration Medical Capability (ExMC) Element Systems Engineering (SE) goals include defining the technical system needed to support medical capabilities for a Mars exploration mission. A draft medical system architecture was developed based on stakeholder needs, system goals, and system behaviors, as captured in an ExMC concept of operations document and a system model. This talk will discuss a high-level view of the medical system, as part of a larger crew health and performance system, both of which will support crew during Deep Space Transport missions. Other mission components, such as the flight system, ground system, caregiver, and patient, will be discussed as aspects of the context because the medical system will have important interactions with each. Additionally, important interactions with other aspects of the crew health and performance system are anticipated, such as health & wellness, mission task performance support, and environmental protection. This talk will highlight areas in which we are working with other disciplines to understand these interactions.

  20. Developing Soft Power Using Afloat Medical Capability

    Science.gov (United States)

    2009-03-02

    engagement with the nations in the Asia -Pacific region contributed to considerable progress across a broad range of security issues. Southeast Asia remains...Forces and the U.S. military has been positive and valuable in the War on Terror and humanitarian assistance.20 The poor economies, overpopulation , weak...Public Health Services combined to conduct a medical and dental civil-assistance program (MEDCAP/DENCAP) visit throughout Southeast Asia and Oceania.42

  1. NASA's Space Launch System: An Enabling Capability for International Exploration

    Science.gov (United States)

    Creech, Stephen D.; May, Todd A.; Robinson, Kimberly F.

    2014-01-01

    As the program moves out of the formulation phase and into implementation, work is well underway on NASA's new Space Launch System, the world's most powerful launch vehicle, which will enable a new era of human exploration of deep space. As assembly and testing of the rocket is taking place at numerous sites around the United States, mission planners within NASA and at the agency's international partners continue to evaluate utilization opportunities for this ground-breaking capability. Developed with the goals of safety, affordability, and sustainability in mind, the SLS rocket will launch the Orion Multi-Purpose Crew Vehicle (MPCV), equipment, supplies, and major science missions for exploration and discovery. NASA is developing this new capability in an austere economic climate, a fact which has inspired the SLS team to find innovative solutions to the challenges of designing, developing, fielding, and operating the largest rocket in history, via a path that will deliver an initial 70 metric ton (t) capability in December 2017 and then continuing through an incremental evolutionary strategy to reach a full capability greater than 130 t. SLS will be enabling for the first missions of human exploration beyond low Earth in almost half a century, and from its first crewed flight will be able to carry humans farther into space than they have ever voyaged before. In planning for the future of exploration, the International Space Exploration Coordination Group, representing 12 of the world's space agencies, has created the Global Exploration Roadmap, which outlines paths toward a human landing on Mars, beginning with capability-demonstrating missions to the Moon or an asteroid. The Roadmap and corresponding NASA research outline the requirements for reference missions for these destinations. SLS will offer a robust way to transport international crews and the air, water, food, and equipment they would need for such missions.

  2. Capable design or designing capabilities? An exploration of service design as an emerging organizational capability in Telenor – Martinkenaite

    Directory of Open Access Journals (Sweden)

    Ieva Martinkenaite

    2017-01-01

    Full Text Available This empirical paper examines a process, starting with the managerial decision to make service design an organizational capability, and follows it as it unfolds over time within one organization. Service design has become an established business practice of how firms create new products and services to promote differentiation in an increasingly uncertain business landscape. Implicit in the literature on service design are assumptions about strategic implications of adopting the prescribed innovation methods and tools. However, little is known about how service design evolves into an organizational capability enabling firms to transform their existing businesses and sustain competitiveness. Through a longitudinal, exploratory case study of service design practices in one of the world’s largest telecommunications companies, we explicate mechanisms through which service design evolves into an organizational capability by exploring the research question: what are the mechanisms through which service design develops into an organizational capability? Our study reveals the effect of an initial introduction of service design tools, identification of boundaryspanning actors and co-alignment of dedicated resources between internal functions, as well as through co-creation with customers. Over time, these activities lead to the adoption of service design practices, and subsequently these practices spark incremental learning throughout the organization, alter managerial decisions and influence multiple paths for the development of new capabilities. Reporting on this process, we are able to describe how service design practices were disseminated and institutionalized within the organization we observed. This study thus contributes by informing how service design can evolve into an organizational capability, as well as by bridging the emerging literature on service design and design thinking with established strategy theory. Further research will have to

  3. A Strategic Approach to Medical Care for Exploration Missions

    Science.gov (United States)

    Canga, Michael A.; Shah, Ronak V.; Mindock, Jennifer A.; Antonsen, Erik L.

    2016-01-01

    Exploration missions will present significant new challenges to crew health, including effects of variable gravity environments, limited communication with Earth-based personnel for diagnosis and consultation for medical events, limited resupply, and limited ability for crew return. Providing health care capabilities for exploration class missions will require system trades be performed to identify a minimum set of requirements and crosscutting capabilities, which can be used in design of exploration medical systems. Medical data, information, and knowledge collected during current space missions must be catalogued and put in formats that facilitate querying and analysis. These data are used to inform the medical research and development program through analysis of risk trade studies between medical care capabilities and system constraints such as mass, power, volume, and training. Medical capability as a quantifiable variable is proposed as a surrogate risk metric and explored for trade space analysis that can improve communication between the medical and engineering approaches to mission design. The resulting medical system design approach selected will inform NASA mission architecture, vehicle, and subsystem design for the next generation of spacecraft.

  4. Overview of an Integrated Medical System for Exploration Missions

    Science.gov (United States)

    Watkins, Sharmila; Rubin, David

    2013-01-01

    The Exploration Medical Capability (ExMC) element of the NASA Human Research Program (HRP) is charged with addressing the risk of unacceptable health and mission outcomes due to limitations of inflight medical capabilities. The Exploration Medical System Demonstration (EMSD) is a project within the ExMC element aimed at reducing this risk by improving the medical capabilities available for exploration missions. The EMSD project will demonstrate, on the ground and on ISS, the integration of several components felt to be essential to the delivery of medical care during long ]duration missions outside of low Earth orbit. The components of the EMSD include the electronic medical record, assisted medical procedure software, medical consumables tracking technology and RFID ] tagged consumables, video conferencing capability, ultrasound device and probes (ground demonstration only), peripheral biosensors, and the software to allow communication among the various components (middleware). This presentation seeks to inform our international partners of the goals and objectives of the EMSD and to foster collaboration opportunities related to this and future projects.

  5. Exploring synchrotron radiation capabilities: The ALS-Intel CRADA

    International Nuclear Information System (INIS)

    Gozzo, F.; Cossy-Favre, A.; Padmore, H.

    1997-01-01

    Synchrotron radiation spectroscopy and spectromicroscopy were applied, at the Advanced Light Source, to the analysis of materials and problems of interest to the commercial semiconductor industry. The authors discuss some of the results obtained at the ALS using existing capabilities, in particular the small spot ultra-ESCA instrument on beamline 7.0 and the AMS (Applied Material Science) endstation on beamline 9.3.2. The continuing trend towards smaller feature size and increased performance for semiconductor components has driven the semiconductor industry to invest in the development of sophisticated and complex instrumentation for the characterization of microstructures. Among the crucial milestones established by the Semiconductor Industry Association are the needs for high quality, defect free and extremely clean silicon wafers, very thin gate oxides, lithographies near 0.1 micron and advanced material interconnect structures. The requirements of future generations cannot be met with current industrial technologies. The purpose of the ALS-Intel CRADA (Cooperative Research And Development Agreement) is to explore, compare and improve the utility of synchrotron-based techniques for practical analysis of substrates of interest to semiconductor chip manufacturing. The first phase of the CRADA project consisted in exploring existing ALS capabilities and techniques on some problems of interest. Some of the preliminary results obtained on Intel samples are discussed here

  6. Human Exploration Systems and Mobility Capability Roadmap Progress Review

    Science.gov (United States)

    Culbert, Chris; Taylor, Jeff

    2005-01-01

    Contents include the following: Capability Roadmap Team. Capability Description and Capability Breakdown Structure. Benefits of the Human Systems and Mobility Capability. Roadmap Process and Approach. Drivers and Assumptions for the whole team. Current State-of-the-Art, Assumptions and Requirements will be covered in the appropriate sections. Capability Presentations by Leads under Roadmap (Repeated for each capability under roadmap). Capability Description, Benefits, Current State-of-the-Art. Capability Requirements and Assumptions. Roadmap for Capability. Capability Readiness Level. Technology Readiness Level. Figures of Merit. Summary of Top Level Capability. Significant Technical Challenges. Summary and Forward Work.

  7. Sustainability, Learning and Capability: Exploring Questions of Balance

    Directory of Open Access Journals (Sweden)

    William A. H. Scott

    2010-12-01

    Full Text Available It is argued that sustainable development makes best sense as a social learning process that brings tangible and useful outcomes in terms of understanding and skills, and also reinforces the motivation and capability for further learning. Thus, there are always balances to be struck between a broad-based, wide-ranging education and a more specialist one; between a focus on ideas themselves, and on their application in social or economic contexts; and between keeping ideas separate, and integrating them. This paper will explore the nature of such balances, and the issues to bear in mind when striking them, focusing on schools, university and college contexts within the United Kingdom.

  8. Exploring the resource and capabilities of food related enterprises in ...

    African Journals Online (AJOL)

    Agribotix GCS 068

    Specifically, the two case studies illustrate the capabilities of business owners to identify assets at their ...... Strategic management and competitive advantage: Concepts .... Journal of Contemporary Hospitality Management 8(6), 427-436.

  9. Production capabilities in US nuclear reactors for medical radioisotopes

    International Nuclear Information System (INIS)

    Mirzadeh, S.; Callahan, A.P.; Knapp, F.F. Jr.; Schenter, R.E.

    1992-11-01

    The availability of reactor-produced radioisotopes in the United States for use in medical research and nuclear medicine has traditionally depended on facilities which are an integral part of the US national laboratories and a few reactors at universities. One exception is the reactor in Sterling Forest, New York, originally operated as part of the Cintichem (Union Carbide) system, which is currently in the process of permanent shutdown. Since there are no industry-run reactors in the US, the national laboratories and universities thus play a critical role in providing reactor-produced radioisotopes for medical research and clinical use. The goal of this survey is to provide a comprehensive summary of these production capabilities. With the temporary shutdown of the Oak Ridge National Laboratory (ORNL) High Flux Isotope Reactor (HFIR) in November 1986, the radioisotopes required for DOE-supported radionuclide generators were made available at the Brookhaven National Laboratory (BNL) High Flux Beam Reactor (HFBR). In March 1988, however, the HFBR was temporarily shut down which forced investigators to look at other reactors for production of the radioisotopes. During this period the Missouri University Research Reactor (MURR) played an important role in providing these services. The HFIR resumed routine operation in July 1990 at 85 MW power, and the HFBR resumed operation in June 1991, at 30 MW power. At the time of the HFBR shutdown, there was no available comprehensive overview which could provide information on status of the reactors operating in the US and their capabilities for radioisotope production. The obvious need for a useful overview was thus the impetus for preparing this survey, which would provide an up-to-date summary of those reactors available in the US at both the DOE-funded national laboratories and at US universities where service irradiations are currently or expected to be conducted

  10. Production capabilities in US nuclear reactors for medical radioisotopes

    Energy Technology Data Exchange (ETDEWEB)

    Mirzadeh, S.; Callahan, A.P.; Knapp, F.F. Jr. (Oak Ridge National Lab., TN (United States)); Schenter, R.E. (Westinghouse Hanford Co., Richland, WA (United States))

    1992-11-01

    The availability of reactor-produced radioisotopes in the United States for use in medical research and nuclear medicine has traditionally depended on facilities which are an integral part of the US national laboratories and a few reactors at universities. One exception is the reactor in Sterling Forest, New York, originally operated as part of the Cintichem (Union Carbide) system, which is currently in the process of permanent shutdown. Since there are no industry-run reactors in the US, the national laboratories and universities thus play a critical role in providing reactor-produced radioisotopes for medical research and clinical use. The goal of this survey is to provide a comprehensive summary of these production capabilities. With the temporary shutdown of the Oak Ridge National Laboratory (ORNL) High Flux Isotope Reactor (HFIR) in November 1986, the radioisotopes required for DOE-supported radionuclide generators were made available at the Brookhaven National Laboratory (BNL) High Flux Beam Reactor (HFBR). In March 1988, however, the HFBR was temporarily shut down which forced investigators to look at other reactors for production of the radioisotopes. During this period the Missouri University Research Reactor (MURR) played an important role in providing these services. The HFIR resumed routine operation in July 1990 at 85 MW power, and the HFBR resumed operation in June 1991, at 30 MW power. At the time of the HFBR shutdown, there was no available comprehensive overview which could provide information on status of the reactors operating in the US and their capabilities for radioisotope production. The obvious need for a useful overview was thus the impetus for preparing this survey, which would provide an up-to-date summary of those reactors available in the US at both the DOE-funded national laboratories and at US universities where service irradiations are currently or expected to be conducted.

  11. Exploring the resource and capabilities of food related enterprises in ...

    African Journals Online (AJOL)

    Specifically, the two case studies illustrate the capabilities of business owners to identify assets at their establishments and the municipality level and reconfigure them into objects aimed at providing experiences for visitors seeking out for rural idyll. The implications of this study on policy and practice on entrepreneurship ...

  12. Career exploration behavior of Korean medical students

    OpenAIRE

    Hyejin An; Seung-Hee Lee

    2017-01-01

    Purpose This study is to analyze the effects of medical students? social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. Methods We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. Results First, we no...

  13. The Exploration of Design Driven Innovation as a Dynamic Capability

    Directory of Open Access Journals (Sweden)

    Philips Kembaren

    2012-01-01

    Full Text Available Innovation enables companies to attain consistent organic growth that brings benefits to stakeholders. Designthinking approach in innovation has been emergent to be an alternative to technological development path inorder to generate competitive and successful product or service in the market place. Design driven innovationcombines functional and semantic dimensions of products or services in the marketplace. Previous researchhas recently revealed practices of design driven innovation in various industries. However, little is known tothe extent that companies in Indonesia practicing design driven innovation. A theoretical framework withperspective from dynamic capability theoretical lens and guided by Dubin’s theory building methodology isproposed to explain the constructs and role of design in the process of innovation. The research is expected tocontribute a new construct to the existing framework, namely construct that related to how we could assessthe value of the design-driven innovation output, perceived by the costumers.Keywords: design driven innovation, dynamic capabilities, theory building

  14. Explore the Capability of ESPAR Antennas for Low Cost Communication

    DEFF Research Database (Denmark)

    Han, Bo; Kalis, A; Papadias, C.

    ESPAR antenna systems are composed of one active and several parasitic elements and by changing the characteristic of the parasitic elements on the antenna, the radiation pattern will also change. Such characteristic makes ESPAR antenna useful in many applications, e.g., single RF MIMO transmission...... and imaginary part. So a matching network is required to control the load value. This paper presents an idea of adjusting the parasitic ESPAR antenna loads with controllable passive elements. According to simulation, the control circuit consumes less than 1mW power on 64 patterns selection, which explores...

  15. Career exploration behavior of Korean medical students

    Directory of Open Access Journals (Sweden)

    Hyejin An

    2017-09-01

    Full Text Available Purpose This study is to analyze the effects of medical students’ social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. Methods We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. Results First, we noted statistically significant gender and admission type difference in social support, career barriers and career exploration behaviors. Second, social support and career barriers were found to influence career exploration behavior as a mediating variable for career decision-making self-efficacy. Conclusion Social support and career barriers as perceived by medical students influenced their career exploration behavior, with their decision-making self-efficacy serving as a full mediator. Therefore, this study has educational implications for career program development and educational training for career decision-making self-efficacy.

  16. Career exploration behavior of Korean medical students.

    Science.gov (United States)

    An, Hyejin; Lee, Seung-Hee

    2017-09-01

    This study is to analyze the effects of medical students' social support and career barriers on career exploration behavior mediated by career decision-making self-efficacy. We applied the t-test to investigate the difference among the variables based on gender and admission types. Also, we performed path analysis to verify the effect of perceived career barriers and social support on career exploration behavior with career decision efficacy as a mediator. First, we noted statistically significant gender and admission type difference in social support, career barriers and career exploration behaviors. Second, social support and career barriers were found to influence career exploration behavior as a mediating variable for career decision-making self-efficacy. Social support and career barriers as perceived by medical students influenced their career exploration behavior, with their decision-making self-efficacy serving as a full mediator. Therefore, this study has educational implications for career program development and educational training for career decision-making self-efficacy.

  17. Exploring female GPs' perceptions about medical leadership.

    Science.gov (United States)

    Price, Karen; Clearihan, Lynette

    2015-06-01

    Women are increasingly entering the Australian general practice workforce. This study aims to explore female general practitioners' (GPs') perceptions of possible barriers to leadership and professional roles in the workforce. A purposive, convenience sample of 30 female GPs in active practice was approached in February, 2012. An anonymous, pa-per-based, semi-quantitative survey sought to identify participation and leadership confidence within general practice in a number of professional roles. The top two barriers participants identified for after-hours medical meetings were energy to attend and geographical location. For after-hours care, the top two barriers identified were energy and self-motivation. Few participants aspired to 'leadership' activities. 'Medical mentoring' was most likely to attract them into leadership. It is important female GPs' perspectives are explored in general practice. This small survey suggests further studies are needed in the importance of energy limitations and lack of self-confidence in restricting female GPs' capacity to fully engage in professional roles.

  18. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities

    OpenAIRE

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed u...

  19. Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

    International Nuclear Information System (INIS)

    Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

    2015-01-01

    Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given

  20. Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

    Science.gov (United States)

    Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

    2015-12-01

    Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

  1. How Should Air Force Expeditionary Medical Capabilities Be Expressed

    Science.gov (United States)

    2009-01-01

    Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Sci- ence, Vol. 4, 2006, pp. 135–146; Sarah A. Lister, Hurricane Katrina: The Public...setting this might mean releasing the patient to a nursing home. In a domestic civilian disaster setting, it may mean releasing the patient to some...described below. The Mobile Aeromedical Staging Facility (MASF) is a 15-person, communications-capable UTC that provides supportive/resuscita- tive nursing

  2. Implementing NASA's Capability-Driven Approach: Insight into NASA's Processes for Maturing Exploration Systems

    Science.gov (United States)

    Williams-Byrd, Julie; Arney, Dale; Rodgers, Erica; Antol, Jeff; Simon, Matthew; Hay, Jason; Larman, Kevin

    2015-01-01

    NASA is engaged in transforming human spaceflight. The Agency is shifting from an exploration-based program with human activities focused on low Earth orbit (LEO) and targeted robotic missions in deep space to a more sustainable and integrated pioneering approach. Through pioneering, NASA seeks to address national goals to develop the capacity for people to work, learn, operate, live, and thrive safely beyond the Earth for extended periods of time. However, pioneering space involves more than the daunting technical challenges of transportation, maintaining health, and enabling crew productivity for long durations in remote, hostile, and alien environments. This shift also requires a change in operating processes for NASA. The Agency can no longer afford to engineer systems for specific missions and destinations and instead must focus on common capabilities that enable a range of destinations and missions. NASA has codified a capability driven approach, which provides flexible guidance for the development and maturation of common capabilities necessary for human pioneers beyond LEO. This approach has been included in NASA policy and is captured in the Agency's strategic goals. It is currently being implemented across NASA's centers and programs. Throughout 2014, NASA engaged in an Agency-wide process to define and refine exploration-related capabilities and associated gaps, focusing only on those that are critical for human exploration beyond LEO. NASA identified 12 common capabilities ranging from Environmental Control and Life Support Systems to Robotics, and established Agency-wide teams or working groups comprised of subject matter experts that are responsible for the maturation of these exploration capabilities. These teams, called the System Maturation Teams (SMTs) help formulate, guide and resolve performance gaps associated with the identified exploration capabilities. The SMTs are defining performance parameters and goals for each of the 12 capabilities

  3. Using A Model-Based Systems Engineering Approach For Exploration Medical System Development

    Science.gov (United States)

    Hanson, A.; Mindock, J.; McGuire, K.; Reilly, J.; Cerro, J.; Othon, W.; Rubin, D.; Urbina, M.; Canga, M.

    2017-01-01

    NASA's Human Research Program's Exploration Medical Capabilities (ExMC) element is defining the medical system needs for exploration class missions. ExMC's Systems Engineering (SE) team will play a critical role in successful design and implementation of the medical system into exploration vehicles. The team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." Development of the medical system is being conducted in parallel with exploration mission architecture and vehicle design development. Successful implementation of the medical system in this environment will require a robust systems engineering approach to enable technical communication across communities to create a common mental model of the emergent engineering and medical systems. Model-Based Systems Engineering (MBSE) improves shared understanding of system needs and constraints between stakeholders and offers a common language for analysis. The ExMC SE team is using MBSE techniques to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. Systems Modeling Language (SysML) is the specific language the SE team is utilizing, within an MBSE approach, to model the medical system functional needs, requirements, and architecture. Modeling methods are being developed through the practice of MBSE within the team, and tools are being selected to support meta-data exchange as integration points to other system models are identified. Use of MBSE is supporting the development of relationships across disciplines and NASA Centers to build trust and enable teamwork, enhance visibility of team goals, foster a culture of unbiased learning and serving, and be responsive to customer needs. The MBSE approach to medical system design offers a paradigm shift toward greater integration between

  4. Decision Analysis Methods Used to Make Appropriate Investments in Human Exploration Capabilities and Technologies

    Science.gov (United States)

    Williams-Byrd, Julie; Arney, Dale C.; Hay, Jason; Reeves, John D.; Craig, Douglas

    2016-01-01

    NASA is transforming human spaceflight. The Agency is shifting from an exploration-based program with human activities in low Earth orbit (LEO) and targeted robotic missions in deep space to a more sustainable and integrated pioneering approach. Through pioneering, NASA seeks to address national goals to develop the capacity for people to work, learn, operate, live, and thrive safely beyond Earth for extended periods of time. However, pioneering space involves daunting technical challenges of transportation, maintaining health, and enabling crew productivity for long durations in remote, hostile, and alien environments. Prudent investments in capability and technology developments, based on mission need, are critical for enabling a campaign of human exploration missions. There are a wide variety of capabilities and technologies that could enable these missions, so it is a major challenge for NASA's Human Exploration and Operations Mission Directorate (HEOMD) to make knowledgeable portfolio decisions. It is critical for this pioneering initiative that these investment decisions are informed with a prioritization process that is robust and defensible. It is NASA's role to invest in targeted technologies and capabilities that would enable exploration missions even though specific requirements have not been identified. To inform these investments decisions, NASA's HEOMD has supported a variety of analysis activities that prioritize capabilities and technologies. These activities are often based on input from subject matter experts within the NASA community who understand the technical challenges of enabling human exploration missions. This paper will review a variety of processes and methods that NASA has used to prioritize and rank capabilities and technologies applicable to human space exploration. The paper will show the similarities in the various processes and showcase instances were customer specified priorities force modifications to the process. Specifically

  5. Exploring a motivation of medical staff.

    Science.gov (United States)

    Goncharuk, Anatoliy G

    2018-06-08

    This paper aims to identify the true motivators (needs) of medical staff, compare them with the current labor incentives, and detect possible differences in motivators for main groups of medical staff. Observing personnel of 5 hospitals and students of the medical institute by special questionnaires, the author confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author used special questionnaires to collect the data. Study results confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author also found significant differences between the motivation of Ukrainian health workers and their colleagues from other countries. The main conclusion is that no matter how we would like to satisfy gender and age equality, all people are individual and what is good for an elderly male doctor cannot be acceptable for a young female nurse. Therefore, forming the motivation system for employees of medical institutions, it is necessary to take into account the age, gender, professions, and other characteristics of each employee. In this way, we can achieve the highest health-care performance. Copyright © 2018 John Wiley & Sons, Ltd.

  6. NASA's Space Launch System: A New Capability for Science and Exploration

    Science.gov (United States)

    Crumbly, Christopher M.; May, Todd A.; Robinson, Kimberly F.

    2014-01-01

    The National Aeronautics and Space Administration's (NASA's) Marshall Space Flight Center (MSFC) is directing efforts to build the Space Launch System (SLS), a heavy-lift rocket that will launch the Orion Multi-Purpose Crew Vehicle (MPCV) and other high-priority payloads into deep space. Its evolvable architecture will allow NASA to begin with human missions beyond the Moon and then go on to transport astronauts or robots to distant places such as asteroids and Mars. Developed with the goals of safety, affordability, and sustainability in mind, SLS will start with 10 percent more thrust than the Saturn V rocket that launched astronauts to the Moon 40 years ago. From there it will evolve into the most powerful launch vehicle ever flown, via an upgrade approach that will provide building blocks for future space exploration. This paper will explain how NASA will execute this development within flat budgetary guidelines by using existing engines assets and heritage technology, from the initial 70 metric ton (t) lift capability through a block upgrade approach to an evolved 130-t capability, and will detail the progress that has already been made toward a first launch in 2017. This paper will also explore the requirements needed for human missions to deep-space destinations and for game-changing robotic science missions, and the capability of SLS to meet those requirements and enable those missions, along with the evolution strategy that will increase that capability. The International Space Exploration Coordination Group, representing 12 of the world's space agencies, has worked together to create the Global Exploration Roadmap, which outlines paths towards a human landing on Mars, beginning with capability-demonstrating missions to the Moon or an asteroid. The Roadmap and corresponding NASA research outline the requirements for reference missions for all three destinations. The SLS will offer a robust way to transport international crews and the air, water, food, and

  7. The clinicide phenomenon: an exploration of medical murder.

    Science.gov (United States)

    Kaplan, Robert

    2007-08-01

    The aim of this paper is to explore the phenomenon of clinicide. The study of medical killers is barely in its infancy. Clinicide is the unnatural death of multiple patients in the course of treatment by a doctor. Serial medical killing is a relatively new phenomenon. The role model is Dr Marcel Petiot, the worst serial killer in French history. More recently, Dr Harold Shipman was Britain's worst serial killer and in the United States and Zimbabwe, Dr Michael Swango killed 60 patients. A number of doctors have such high patient death rates that it cannot be ignored. At some level, these doctors have an awareness of what they are doing, countered by an overweening refusal to acknowledge the implications or desist from further treatment. Treatment killer offences usually occur on the basis of serial mental illness, but may include the contentious area of euthanasia killing. Doctors have frequently been accomplices in state repression, brutality and genocide in direct contravention to their sanctioned role to relieve suffering and save life. They have become mass murderers on an exponential scale, making any comparison with a doctor killing his own patients almost risible. Many clinicidal doctors have extreme narcissistic personalities, a grandiose view of their own capability and inability to accept that they could be criticized or need assistance from other doctors. Such doctors develop a God-complex, getting a vicarious thrill out of ending suffering and by determining when a person dies.

  8. Capability and Technology Performance Goals for the Next Step in Affordable Human Exploration of Space

    Science.gov (United States)

    Linne, Diane L.; Sanders, Gerald B.; Taminger, Karen M.

    2015-01-01

    The capability for living off the land, commonly called in-situ resource utilization, is finally gaining traction in space exploration architectures. Production of oxygen from the Martian atmosphere is called an enabling technology for human return from Mars, and a flight demonstration to be flown on the Mars 2020 robotic lander is in development. However, many of the individual components still require technical improvements, and system-level trades will be required to identify the best combination of technology options. Based largely on work performed for two recent roadmap activities, this paper defines the capability and technology requirements that will need to be achieved before this game-changing capability can reach its full potential.

  9. Medical home capabilities of primary care practices that serve sociodemographically vulnerable neighborhoods.

    Science.gov (United States)

    Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Schneider, Eric C

    2010-06-14

    Under current medical home proposals, primary care practices using specific structural capabilities will receive enhanced payments. Some practices disproportionately serve sociodemographically vulnerable neighborhoods. If these practices lack medical home capabilities, their ineligibility for enhanced payments could worsen disparities in care. Via survey, 308 Massachusetts primary care practices reported their use of 13 structural capabilities commonly included in medical home proposals. Using geocoded US Census data, we constructed racial/ethnic minority and economic disadvantage indices to describe the neighborhood served by each practice. We compared the structural capabilities of "disproportionate-share" practices (those in the most sociodemographically vulnerable quintile on each index) and others. Racial/ethnic disproportionate-share practices were more likely than others to have staff assisting patient self-management (69% vs 55%; P = .003), on-site language interpreters (54% vs 26%; P primary care practices serving sociodemographically vulnerable neighborhoods were more likely than other practices to have structural capabilities commonly included in medical home proposals. Payments tied to these capabilities may aid practices serving vulnerable populations.

  10. Clinical capabilities of graduates of an outcomes-based integrated medical program

    Directory of Open Access Journals (Sweden)

    Scicluna Helen A

    2012-06-01

    Full Text Available Abstract Background The University of New South Wales (UNSW Faculty of Medicine replaced its old content-based curriculum with an innovative new 6-year undergraduate entry outcomes-based integrated program in 2004. This paper is an initial evaluation of the perceived and assessed clinical capabilities of recent graduates of the new outcomes-based integrated medical program compared to benchmarks from traditional content-based or process-based programs. Method Self-perceived capability in a range of clinical tasks and assessment of medical education as preparation for hospital practice were evaluated in recent graduates after 3 months working as junior doctors. Responses of the 2009 graduates of the UNSW’s new outcomes-based integrated medical education program were compared to those of the 2007 graduates of UNSW’s previous content-based program, to published data from other Australian medical schools, and to hospital-based supervisor evaluations of their clinical competence. Results Three months into internship, graduates from UNSW’s new outcomes-based integrated program rated themselves to have good clinical and procedural skills, with ratings that indicated significantly greater capability than graduates of the previous UNSW content-based program. New program graduates rated themselves significantly more prepared for hospital practice in the confidence (reflective practice, prevention (social aspects of health, interpersonal skills (communication, and collaboration (teamwork subscales than old program students, and significantly better or equivalent to published benchmarks of graduates from other Australian medical schools. Clinical supervisors rated new program graduates highly capable for teamwork, reflective practice and communication. Conclusions Medical students from an outcomes-based integrated program graduate with excellent self-rated and supervisor-evaluated capabilities in a range of clinically-relevant outcomes. The program

  11. Exploring leadership capability and emotional intelligence as moderators of workplace bullying.

    Science.gov (United States)

    Hutchinson, Marie; Hurley, John

    2013-04-01

    This study aimed to explore the potential for emotionally intelligent leadership as a way to mitigate bullying behaviour within nursing workplace environments. As the body of evidence about bullying continues to grow there is an increasing need for researchers to direct their attention to developing theoretical frameworks that explain how bullying and victimization occur, and the types of strategies that may address the problem. The narrative synthesis of the literature presented in this paper is forwarded as supporting the need for strengthening leadership capability, especially those capabilities associated with emotional intelligence, as a means of diminishing experienced bullying within nursing. Stemming from our expanding understandings about bullying is an appreciation of the range of factors within organizations that influence the occurrence of bullying, and an awareness of the need to understand the expression, experience and management of emotions in the workplace. While both leadership and emotional intelligence capabilities offer real potential to mitigate bullying behaviour, disparity exits between clinical and managerial nurses toward preferred leadership styles and emotional intelligence is open to challenges towards its content validity. Nursing management is challenged to build upon procedural responses to bullying to include a ground up approach to leadership enhancement capability, better responses to emotions in the workplace and supporting the interpersonal and intrapersonal capabilities of the nursing workforce. © 2012 Blackwell Publishing Ltd.

  12. Medical capability team: the clinical microsystem for combat healthcare delivery in counterinsurgency operations.

    Science.gov (United States)

    Clark, Susz; Van Steenvort, Jon K

    2008-01-01

    Today's operational environment in the support of counterinsurgency operations requires greater tactical and operational flexibility and diverse medical capabilities. The skills and organizations required for full spectrum medical operations are different from those of the past. Combat healthcare demands agility and the capacity for rapid change in clinical systems and processes to better support the counterinsurgency environment. This article proposes the Army Medical Department (AMEDD) develop and implement the medical capability team (MCT) for combat healthcare delivery. It discusses using the concept of the brigade combat team to develop medical capability teams as the unit of effectiveness to transform frontline care; provides a theoretical overview of the MCT as a "clinical microsystem"; discusses MCT leadership, training, and organizational support, and the deployment and employment of the MCT in a counterinsurgency environment. Additionally, this article proposes that the AMEDD initiate the development of an AMEDD Combat Training Center of Excellence to train and validate the MCTs. The complexity of combat healthcare demands an agile and campaign quality AMEDD with joint expeditionary capability in order to promote the best patient outcomes in a counterinsurgency environment.

  13. Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

    Science.gov (United States)

    Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

    2014-01-01

    Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

  14. Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

    Directory of Open Access Journals (Sweden)

    Abbasali Ebrahimian

    2014-01-01

    Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

  15. Readiness for the Patient-Centered Medical Home: structural capabilities of Massachusetts primary care practices.

    Science.gov (United States)

    Friedberg, Mark W; Safran, Dana G; Coltin, Kathryn L; Dresser, Marguerite; Schneider, Eric C

    2009-02-01

    The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied. To measure the prevalence of recommended structural capabilities among primary care practices and to determine whether prevalence varies among practices of different size (number of physicians) and administrative affiliation with networks of practices. Cross-sectional analysis. One physician chosen at random from each of 412 primary care practices in Massachusetts was surveyed about practice capabilities during 2007. Practice size and network affiliation were obtained from an existing database. Presence of 13 structural capabilities representing 4 domains relevant to quality: patient assistance and reminders, culture of quality, enhanced access, and electronic health records (EHRs). Three hundred eight (75%) physicians responded, representing practices with a median size of 4 physicians (range 2-74). Among these practices, 64% were affiliated with 1 of 9 networks. The prevalence of surveyed capabilities ranged from 24% to 88%. Larger practice size was associated with higher prevalence for 9 of the 13 capabilities spanning all 4 domains (P < 0.05). Network affiliation was associated with higher prevalence of 5 capabilities (P < 0.05) in 3 domains. Associations were not substantively altered by statistical adjustment for other practice characteristics. Larger and network-affiliated primary care practices are more likely than smaller, non-affiliated practices to have adopted several recommended capabilities. In order to achieve PCMH designation, smaller non-affiliated practices may require the greatest investments.

  16. Exploring the potential use of augmented reality in medical education

    OpenAIRE

    Orraryd, Pontus

    2017-01-01

    Human anatomy is traditionally taught using textbooks and dissections. With the advent of computer graphics, using 3D applications have started to see much more use in medical educations around the world. Today, technology such as Augmented Reality and Virtual Reality are on everybody’s lips, and many are now curious what we can do with this new technology. This thesis explores how Augmented Reality can be used in medical education to teach human anatomy. Two application prototypes were devel...

  17. Security protection of DICOM medical images using dual-layer reversible watermarking with tamper detection capability.

    Science.gov (United States)

    Tan, Chun Kiat; Ng, Jason Changwei; Xu, Xiaotian; Poh, Chueh Loo; Guan, Yong Liang; Sheah, Kenneth

    2011-06-01

    Teleradiology applications and universal availability of patient records using web-based technology are rapidly gaining importance. Consequently, digital medical image security has become an important issue when images and their pertinent patient information are transmitted across public networks, such as the Internet. Health mandates such as the Health Insurance Portability and Accountability Act require healthcare providers to adhere to security measures in order to protect sensitive patient information. This paper presents a fully reversible, dual-layer watermarking scheme with tamper detection capability for medical images. The scheme utilizes concepts of public-key cryptography and reversible data-hiding technique. The scheme was tested using medical images in DICOM format. The results show that the scheme is able to ensure image authenticity and integrity, and to locate tampered regions in the images.

  18. The Pathway to a Safe and Effective Medication Formulary for Exploration Spaceflight

    Science.gov (United States)

    Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; Mcguire, R. K. M.; Antonsen, E. L.

    2017-01-01

    PURPOSE: Exploration space missions pose several challenges to providing a comprehensive medication formulary designed to accommodate the size and space limitations of the spacecraft; while addressing the individual medications needs and preferences of the Crew; the negative outcome of a degrading inventory over time, the inability to resupply before expiration dates; and the need to properly forecast the best possible medication candidates to treat conditions that will occur in the future. METHODS: The Pharmacotherapeutics Discipline has partnered with the Exploration Medical Capabilities (ExMC) Element to develop and propose a research pathway that is comprehensively focused on evidence-based models and theories, as well as on new diagnostic tools and treatments or preventive measures aimed at closure of the Med02 “Pharmacy” Gap; defined in the Human Research Program’s (HRP) risk-based research strategy. The Med02 Gap promotes the challenge to identify a strategy to ensure that medications used to treat medical conditions during exploration space missions are available, safe, and effective. It is abundantly clear that pharmaceutical intervention is an essential component of risk management planning for astronaut healthcare during exploration space. However, the quandary still remains of how to assemble a formulary that is comprehensive enough to prevent or treat anticipated medical events; and is also chemically stable, safe, and robust enough to have sufficient potency to last for the duration of an exploration space mission. In cases where that is not possible, addressing this Gap requires exploration of novel drug development techniques, dosage forms, and dosage delivery platforms that enhance chemical stability as well as therapeutic effectiveness. RESULTS: The proposed research pathway outlines the steps, processes, procedures, and a research portfolio aimed at identifying a capability that will provide a safe and effective pharmacy for any specific

  19. Exploring the tensions of being and becoming a medical educator.

    Science.gov (United States)

    Sethi, Ahsan; Ajjawi, Rola; McAleer, Sean; Schofield, Susie

    2017-03-23

    Previous studies have identified tensions medical faculty encounter in their roles but not specifically those with a qualification in medical education. It is likely that those with postgraduate qualifications may face additional tensions (i.e., internal or external conflicts or concerns) from differentiation by others, greater responsibilities and translational work against the status quo. This study explores the complex and multi-faceted tensions of educators with qualifications in medical education at various stages in their career. The data described were collected in 2013-14 as part of a larger, three-phase mixed-methods research study employing a constructivist grounded theory analytic approach to understand identity formation among medical educators. The over-arching theoretical framework for the study was Communities of Practice. Thirty-six educators who had undertaken or were undertaking a postgraduate qualification in medical education took part in semi-structured interviews. Participants expressed multiple tensions associated with both becoming and being a healthcare educator. Educational roles had to be juggled with clinical work, challenging their work-life balance. Medical education was regarded as having lower prestige, and therefore pay, than other healthcare career tracks. Medical education is a vast speciality, making it difficult as a generalist to keep up-to-date in all its areas. Interestingly, the graduates with extensive experience in education reported no fears, rather asserting that the qualification gave them job variety. This is the first detailed study exploring the tensions of educators with postgraduate qualifications in medical education. It complements and extends the findings of the previous studies by identifying tensions common as well as specific to active students and graduates. These tensions may lead to detachment, cynicism and a weak sense of identity among healthcare educators. Postgraduate programmes in medical education

  20. Exploring emotional intelligence in a Caribbean medical school.

    Science.gov (United States)

    Sa, B; Baboolal, N; Williams, S; Ramsewak, S

    2014-03-01

    To explore the emotional intelligence (EI) in medical students in a Caribbean medical school and investigate its association with gender, age, year of study and ethnicity. A cross-sectional design using convenient sampling of 304 years two to five undergraduate medical students at the School of Medicine, the University of the West Indies (UWI), St Augustine campus, was conducted. The Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-V2.0) was administered to test four branches of EI: perceiving emotions, facilitating thought, understanding emotions and managing emotions. Data were analysed using SPSS version 19. T-test, analysis of variance (ANOVA) and r (product moment correlation) were calculated to establish the effects of selected variables (gender, age, year of study and ethnicity) on total and sub-scales EI scores and tested against 0.05 and 0.01 significance levels. The total mean score for EI fell within the average according to MSCEIT standards. Gender analysis showed significantly higher scores for males and for younger age groups (maturity and emotional stability. It would be valuable to widen this study by including other UWI campuses and offshore medical schools in the Caribbean. This preliminary study examined a sample of medical students from a well-established Caribbean medical school. Since EI is considered to be important in the assessment and training of medical undergraduates, consideration should be given to introducing interventions aimed at increasing EI.

  1. Human Exploration Mission Capabilities to the Moon, Mars, and Near Earth Asteroids Using ''Bimodal'' NTR Propulsion

    International Nuclear Information System (INIS)

    Stanley K. Borowski; Leonard A. Dudzinski; Melissa L. McGuire

    2000-01-01

    The nuclear thermal rocket (NTR) is one of the leading propulsion options for future human exploration missions because of its high specific impulse (Isp ∼ 850 to 1000 s) and attractive engine thrust-to-weight ratio (∼ 3 to 10). Because only a minuscule amount of enriched 235 U fuel is consumed in an NRT during the primary propulsion maneuvers of a typical Mars mission, engines configured both for propulsive thrust and modest power generation (referred to as 'bimodal' operation) provide the basis for a robust, power-rich stage with efficient propulsive capture capability at the moon and near-earth asteroids (NEAs), where aerobraking cannot be utilized. A family of modular bimodal NTR (BNTR) space transfer vehicles utilize a common core stage powered by three ∼15-klb f engines that produce 50 kW(electric) of total electrical power for crew life support, high data rate communications with Earth, and an active refrigeration system for long-term, zero-boiloff liquid hydrogen (LH 2 ) storage. This paper describes details of BNTR engines and designs of vehicles using them for various missions

  2. Taking a Capability Approach to Technology and Its Design : A Philosophical Exploration

    NARCIS (Netherlands)

    Oosterlaken, E.T.

    2013-01-01

    What people are realistically able to do and be in their lives, their capabilities, are of central moral importance according to the capability approach (CA) of Amartya Sen and Martha Nussbaum. Examples are the capabilities to be healthy or to be part of a community. The CA has become an influential

  3. National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Capability Roadmap Development for Exploration

    Science.gov (United States)

    Bagdigian, Robert M.; Carrasquillo, Robyn L.; Metcalf, Jordan; Peterson, Laurie

    2012-01-01

    NASA is considering a number of future human space exploration mission concepts. Although detailed requirements and vehicle architectures remain mostly undefined, near-term technology investment decisions need to be guided by the anticipated capabilities needed to enable or enhance the mission concepts. This paper describes a roadmap that NASA has formulated to guide the development of Environmental Control and Life Support Systems (ECLSS) capabilities required to enhance the long-term operation of the International Space Station (ISS) and enable beyond-Low Earth Orbit (LEO) human exploration missions. Three generic mission types were defined to serve as a basis for developing a prioritized list of needed capabilities and technologies. Those are 1) a short duration micro gravity mission; 2) a long duration transit microgravity mission; and 3) a long duration surface exploration mission. To organize the effort, ECLSS was categorized into three major functional groups (atmosphere, water, and solid waste management) with each broken down into sub-functions. The ability of existing, flight-proven state-of-the-art (SOA) technologies to meet the functional needs of each of the three mission types was then assessed. When SOA capabilities fell short of meeting the needs, those "gaps" were prioritized in terms of whether or not the corresponding capabilities enable or enhance each of the mission types. The resulting list of enabling and enhancing capability gaps can be used to guide future ECLSS development. A strategy to fulfill those needs over time was then developed in the form of a roadmap. Through execution of this roadmap, the hardware and technologies needed to enable and enhance exploration may be developed in a manner that synergistically benefits the ISS operational capability, supports Multi-Purpose Crew Vehicle (MPCV) development, and sustains long-term technology investments for longer duration missions. This paper summarizes NASA s ECLSS capability roadmap

  4. Exploring the notion of a 'capability for uncertainty' and the implications for leader development

    Directory of Open Access Journals (Sweden)

    Kathy Bennett

    2016-10-01

    Full Text Available Orientation: With uncertainty increasingly defining organisational contexts, executive leaders need to develop their ‘capability for uncertainty’ – the ability to engage with uncertainty in their organisational context and to lead others, while simultaneously managing their own experience of uncertainty. However, what constitutes such a holistic ‘capability for uncertainty’ is not clear. Research purpose: The purpose was to gain an understanding of what constitutes a capability for uncertainty. Motivation for the study: Gaining an understanding of what components constitute leaders’ capability for uncertainty would provide a basis for determining what interventions would be relevant for developing leaders towards achieving such a capability. Research approach, design and method: An interpretive qualitative approach was adopted, using interpretative phenomenological analysis to gain an understanding of what capability executive leaders developed through their lived experience of uncertainty. Two purposive samples of six executive leaders from two different South African companies (a private company and a state-owned company, which had both been experiencing long-term organisational uncertainty prior to and up to the time of the study, were used. Data were collected through semi-structured interviews. Main findings: The executives all developed their capability for uncertainty through lived experiences of uncertainty, to a greater or lesser extent. Five components were identified as constituting a holistic capability for uncertainty, as follows: a sense of positive identity, an acceptance of uncertainty, effective sense-making, learning agility and relevant leadership practices during organisational uncertainty. Practical/managerial implications: Organisations need to target and design leader development interventions to specifically develop these components of a holistic capability for uncertainty in executives and leaders, enabling

  5. Designing Technology: An Exploration of the Relationship between Technological Literacy and Design Capability

    Science.gov (United States)

    Hope, Gill

    2013-01-01

    The aim of this article is to contribute to the debate on the nature of technology education. This is especially pertinent at times of curriculum change and uncertainty, such as currently exist in relation to the Primary school curriculum in England and Wales. Two phrases ("technological literacy" and "design capability") have…

  6. What is nature capable of? Evidence, ontology and speculative medical humanities.

    Science.gov (United States)

    Savransky, Martin; Rosengarten, Marsha

    2016-09-01

    Expanding on the recent call for a 'critical medical humanities' to intervene in questions of the ontology of health, this article develops a what we call a 'speculative' orientation to such interventions in relation to some of the ontological commitments on which contemporary biomedical cultures rest. We argue that crucial to this task is an approach to ontology that treats it not as a question of first principles, but as a matter of the consequences of the images of nature that contemporary biomedical research practices espouse when they make claims to evidence, as well as the possible consequences of imagining different worlds in which health and disease processes partake. By attending to the implicit ontological assumptions involved in the method par excellence of biomedical research, namely the randomised controlled trial (RCT), we argue that the mechanistic ontology that tacitly informs evidence-based biomedical research simultaneously authorises a series of problematic consequences for understanding and intervening practically in the concrete realities of health. As a response, we develop an alternative ontological proposition that regards processes of health and disease as always situated achievements. We show that, without disqualifying RCT-based evidence, such a situated ontology enables one to resist the reduction of the realities of health and disease to biomedicine's current forms of explanation. In so doing, we call for medical humanities scholars to actively engage in the speculative question of what nature may be capable of. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Exploring Leadership Capability Team Leaders for Construction Industry in Malaysia: Training and Experience

    Science.gov (United States)

    Muda, W. H. N. Wan; Halim, F. Ab; Libunao, W. H.

    2017-08-01

    It has been said that the construction industry must unleash its potential as a source of wealth creation and provide opportunity for the betterment of quality of life. In ensuring the quality of workmanship at construction sites, supervisory skills of site supervisors need to be enhanced. It stressed out that to match business growth and excellence overseas, we must recognize and act on the importance of continuously developing niche expertise and capabilities. Undoubtedly, the role of research in determining the specific leadership skills and the needed core capabilities cannot be over-emphasized. In ensuring the quality of workmanship at construction sites, leadership skills especially supervisory skill for site supervisors need to be enhanced. In this study, quantitative research design with survey questionnaire was used to collect the data and simple random sampling was employed in selecting 248 respondents involving team leaders in construction industry from whole of Malaysia. The data was analyzed using descriptive and inferential statistics; ANOVA in SPSS 21.0. Training and experience in leadership has been found to be significance to leadership capability of team leaders. The opinions from the respondents also indicated that they need the training of leadership and they had to enhance themselves to enable them to become better and more competitive leaders. The results of this assessment can pinpoint the areas needing improvement and therefore can be used as basis in designing and/or deciding development programmes. This study also found that generally the team leaders in construction industry needed more opportunities to expand their leadership capability to become the effective leaders in future.

  8. On the Capability of Smartphones to Perform as Communication Gateways in Medical Wireless Personal Area Networks

    Directory of Open Access Journals (Sweden)

    María José Morón

    2014-01-01

    Full Text Available This paper evaluates and characterizes the technical performance of medicalwireless personal area networks (WPANs that are based on smartphones. For this purpose,a prototype of a health telemonitoring system is presented. The prototype incorporates acommercial Android smartphone, which acts as a relay point, or “gateway”, between a setof wireless medical sensors and a data server. Additionally, the paper investigates if theconventional capabilities of current commercial smartphones can be affected by their useas gateways or “Holters” in health monitoring applications. Specifically, the profiling hasfocused on the CPU and power consumption of the mobile devices. These metrics havebeen measured under several test conditions modifying the smartphone model, the type ofsensors connected to the WPAN, the employed Bluetooth profile (SPP (serial port profile orHDP (health device profile, the use of other peripherals, such as a GPS receiver, the impactof the use of theWi-Fi interface or the employed method to encode and forward the data thatare collected from the sensors.

  9. Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

    Science.gov (United States)

    Gupta, Sameer; Boehme, Jacqueline; Manser, Kelly; Dewar, Jannine; Miller, Amie; Siddiqui, Gina; Schwaitzberg, Steven D

    2016-10-01

    Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation. © The Author(s) 2016.

  10. In-Space Assembly Capability Assessment for Potential Human Exploration and Science Applications

    Science.gov (United States)

    Jefferies, Sharon A.; Jones, Christopher A.; Arney, Dale C.; Stillwagen, Frederic H.; Chai, Patrick R.; Hutchinson, Craig D.; Stafford, Matthew A.; Moses, Robert W.; Dempsey, James A.; Rodgers, Erica M.; hide

    2017-01-01

    Human missions to Mars present several major challenges that must be overcome, including delivering multiple large mass and volume elements, keeping the crew safe and productive, meeting cost constraints, and ensuring a sustainable campaign. Traditional methods for executing human Mars missions minimize or eliminate in-space assembly, which provides a narrow range of options for addressing these challenges and limits the types of missions that can be performed. This paper discusses recent work to evaluate how the inclusion of in-space assembly in space mission architectural concepts could provide novel solutions to address these challenges by increasing operational flexibility, robustness, risk reduction, crew health and safety, and sustainability. A hierarchical framework is presented to characterize assembly strategies, assembly tasks, and the required capabilities to assemble mission systems in space. The framework is used to identify general mission system design considerations and assembly system characteristics by assembly strategy. These general approaches are then applied to identify potential in-space assembly applications to address each challenge. Through this process, several focus areas were identified where applications of in-space assembly could affect multiple challenges. Each focus area was developed to identify functions, potential assembly solutions and operations, key architectural trades, and potential considerations and implications of implementation. This paper helps to identify key areas to investigate were potentially significant gains in addressing the challenges with human missions to Mars may be realized, and creates a foundation on which to further develop and analyze in-space assembly concepts and assembly-based architectures.

  11. A grounded exploration of the dimensions of managerial capability: A preliminary study of top Australian pharmacist owner-managers.

    Science.gov (United States)

    Woods, Phillip; Gapp, Rod; King, Michelle A

    2015-01-01

    Australian community pharmacies are experiencing challenges, including government prescription pricing reform and a dramatically increasing competitive environment. Enacting appropriate responsive actions requires capable pharmacy managers. 'Capability' implies managing effectively in the present, but with unknown or emerging contexts and with new problems. A conceptual understanding of managerial capability as practiced by pharmacist owner-managers is unavailable in the literature. This research aimed to address the question: How can we understand managerial capability in relation to effective community pharmacy management? The study's objective was to develop preliminary theoretical departure points for continuing research responding to the research question. The objective was approached by exploring how 5 top Australian pharmacy owner-managers accomplish the management of their businesses in a changing business environment. Qualitative research methods were employed to develop a social process perspective of how the managers enact their management practices. In-depth semi-structured life-world interviews were undertaken as the major method of data collection. Interview text thematic analysis was carried out identifying rich conceptual properties and dimensions, which 'dimensionalized' 3 key integrated categories. The findings show how the managers are immersed in their business, managerial and personal practices in a holistic and relational manner. Managerial processes, reported through three conceptual categories, their properties and dimensions, reveal the highly situational nature of the reality the managers were experiencing, including their need to express their personal/professional identity. The properties and dimensions of the category 'learning generatively' in particular, reveal how the pharmacy owner-managers shape their business activities and their emerging context as time passes. The preliminary interpretive view of managerial capability describes

  12. Exploring the impact of dynamic capabilities on sustainable supply chain firm's performance using Grey-Analytical Hierarchy Process

    DEFF Research Database (Denmark)

    Govindan, Kannan; Mathivathanan, Deepak; Haq, A. Noorul

    2017-01-01

    Dynamic capabilities (DCs) are the inherent capabilities developed by firms through the implementation of Sustainable Supply Chain practices. These DCs serve as a backbone for the firms to achieve competitive advantages in contemporary ever-changing markets. The present study focuses on exploring...... industrial managers to identify specific influential DCs for each performance measure category by overcoming the limitations of few experts through the application of the grey multi criteria decision making system. Identifying and prioritizing performance-specific DCs allow sustainable supply chain oriented...... performance measures identified from the literature. First, through a questionnaire survey with industrial experts from south India as respondents, the initial list of 77 DCs is confined to a list of 40 essential DCs. Second, the shortlisted 40 DCs are grouped under six performance measures; a logical...

  13. Effective Exploration of New 760°C-Capability Steels for Coal Energy

    Energy Technology Data Exchange (ETDEWEB)

    Clark, Williams [The Ohio State Univ., Columbus, OH (United States); Zhao, Ji-Cheng [The Ohio State Univ., Columbus, OH (United States)

    2016-09-17

    Cost effective and high performance alloys that are capable of operating at 760 °C or higher for extended periods of time under a very aggressive environment are critically required for the design and development of advanced ultrasupercritical (AUSC) boilers and steam turbines. Finely dispersed Laves phase precipitates have been shown by Takeyama and co-workers to be a viable strengthening mechanism in high temperature austenitic steels. There is currently no straightforward theory that can predict what other intermetallic phases can serve as potent precipitation-strengthening phases for steels; thus we employed a highly effective dual-anneal diffusion multiple (DADM) approach to screen for viable strengthening precipitates over a wide range of compositions. From the Fe-Co-Cr-Ni-Mo DADMs, the Fe-Cr-Mo based Chi phase was identified as a new strengthening phase for high temperature ferritic steels; and from the Fe-Mn-Cr-Nb-Ni-Mo-FeAl DADMs, the Laves phase was identified as a viable strengthening precipitate in Fe-Mn and Fe-Ni based austenitic steels. After identification of viable strengthening phases from the DADMs that covered compositions in the basic ternary and quaternary systems, we employed computation thermodynamics to perform multicomponent alloy design and optimization. For the new the Chi-phase strengthened steels, we performed thermodynamic calculations to vary the volume fraction of the Chi phase and introduced Nb and carbon to promote the formation of stable carbides for grain size control during solution heat treatment. For the Fe-Ni-Mn based austenitic steels, we performed extensive parametric optimization of compositions in order to reduce the expensive Ni content, add Cr and Al for oxidation resistance, and balance the alloying contents (Ni, Mn, Cr, Al, Mo) to suppress the ferritic phase and promote the austenitic matrix phase. Four steels (two ferritic + two austenitic) were designed and tested. The two Chi-phase strengthened ferritic steels

  14. Exploring the use of smartphones and tablets by medical House ...

    African Journals Online (AJOL)

    The Ministry of Health in Ghana has an e-Health strategy, with the aim of integrating such resources into ... into medical practice can be improved by integration with the medical curriculum and accepted practice ..... The likelihood of this being.

  15. Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus

    OpenAIRE

    Kirby, Sheila Nataraj; Marsh, Julie A.; Thie, Harry J.

    2011-01-01

    In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organizati...

  16. Teaching medical students to express empathy by exploring patient emotions and experiences in standardized medical encounters.

    Science.gov (United States)

    Ruiz-Moral, Roger; Pérula de Torres, Luis; Monge, Diana; García Leonardo, Cristina; Caballero, Fernando

    2017-09-01

    To increase medical students' ability to detect contextual and emotional cues and to respond empathetically to patients. a training course in communication skills and patient-centered care with different teaching activities (didactic, reflective and interactive: workshops and encounters with simulated patients) was delivered to third-year medical students just before their clerkships. The program was evaluated by an external observer (OE) and simulated patients (SP) in 2 or 3 videotaped encounters. Students improved significantly from baseline to 3rd interview in all communicative skills and domains explored both in OE (32.4%) and SP (38.3%) measurement. At the end of the course students detected significantly more clues and made more empathetic expressions. The course seems to improve the ability of students to explore the illness experience, showing more empathy in a more genuine way. This was carried out in consultations lasting 10min. The program is effective and feasible to be applied as a regular formative activity. Further research is needed to assess whether this training program is applicable to students in more advanced educational levels and if it has any additional outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Potential Applications of Modularity to Enable a Deep Space Habitation Capability for Future Human Exploration Beyond Low-Earth Orbit

    Science.gov (United States)

    Simon, Matthew A.; Toups, Larry; Smitherman, David

    2012-01-01

    Evaluating preliminary concepts of a Deep Space Habitat (DSH) enabling long duration crewed exploration of asteroids, the Moon, and Mars is a technically challenging problem. Sufficient habitat volumes and equipment, necessary to ensure crew health and functionality, increase propellant requirements and decrease launch flexibility to deliver multiple elements on a single launch vehicle; both of which increase overall mission cost. Applying modularity in the design of the habitat structures and subsystems can alleviate these difficulties by spreading the build-up of the overall habitation capability across several smaller parts. This allows for a more flexible habitation approach that accommodates various crew mission durations and levels of functionality. This paper provides a technical analysis of how various modular habitation approaches can impact the parametric design of a DSH with potential benefits in mass, packaging volume, and architectural flexibility. This includes a description of the desired long duration habitation capability, the definition of a baseline model for comparison, a small trade study to investigate alternatives, and commentary on potentially advantageous configurations to enable different levels of habitability. The approaches investigated include modular pressure vessel strategies, modular subsystems, and modular manufacturing approaches to habitat structure. The paper also comments upon the possibility of an integrated habitation strategy using modular components to create all short and long duration habitation elements required in the current exploration architectures.

  18. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study

    NARCIS (Netherlands)

    Smeulers, Marian; Onderwater, Astrid T.; van Zwieten, Myra C. B.; Vermeulen, Hester

    2014-01-01

    To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative

  19. A triple helix model of medical innovation: Supply, demand, and technological capabilities in terms of Medical Subject Headings

    NARCIS (Netherlands)

    Petersen, A.M.; Rotolo, D.; Leydesdorff, L.

    We develop a model of innovation that enables us to trace the interplay among three key dimensions of the innovation process: (i) demand of and (ii) supply for innovation, and (iii) technological capabilities available to generate innovation in the forms of products, processes, and services.

  20. What is the role of community capabilities for maternal health? An exploration of community capabilities as determinants to institutional deliveries in Bangladesh, India, and Uganda

    Directory of Open Access Journals (Sweden)

    Ligia Paina

    2016-11-01

    Full Text Available Abstract Background While community capabilities are recognized as important factors in developing resilient health systems and communities, appropriate metrics for these have not yet been developed. Furthermore, the role of community capabilities on access to maternal health services has been underexplored. In this paper, we summarize the development of a community capability score based on the Future Health System (FHS project’s experience in Bangladesh, India, and Uganda, and, examine the role of community capabilities as determinants of institutional delivery in these three contexts. Methods We developed a community capability score using a pooled dataset containing cross-sectional household survey data from Bangladesh, India, and Uganda. Our main outcome of interest was whether the woman delivered in an institution. Our predictor variables included the community capability score, as well as a series of previously identified determinants of maternal health. We calculate both population-averaged effects (using GEE logistic regression, as well as sub-national level effects (using a mixed effects model. Results Our final sample for analysis included 2775 women, of which 1238 were from Bangladesh, 1199 from India, and 338 from Uganda. We found that individual-level determinants of institutional deliveries, such as maternal education, parity, and ante-natal care access were significant in our analysis and had a strong impact on a woman’s odds of delivering in an institution. We also found that, in addition to individual-level determinants, greater community capability was significantly associated with higher odds of institutional delivery. For every additional capability, the odds of institutional delivery would increase by up to almost 6 %. Conclusion Individual-level characteristics are strong determinants of whether a woman delivered in an institution. However, we found that community capability also plays an important role, and should be

  1. A PERSPECTIVE ON MILITARY MEDICAL SERVICE ROLE IN STABILIZATION OPERATIONS: EXPANSION OF AIR FORCE MEDICAL SERVICE CAPABILITIES INMEDICAL DIPLOMACY

    Science.gov (United States)

    2017-04-06

    global and regional international organizations (IOs), US and foreign nongovernmental organizations ( NGOs ), and private-sector individuals and for-profit...iv Abstract This research paper advocates that the US military health workers will be more effective in medical diplomacy than their NGO ...organizations (IO), and non-governmental organizations ( NGO ), provided humanitarian assistance to bring social stability to affected regions. In

  2. Response capabilities of the National Guard: a focus on domestic disaster medical response.

    Science.gov (United States)

    Bochicchio, Daniel

    2010-01-01

    The National Guard has a 373-year history of responding to the nation's call to duty for service both at home and abroad (The National Guard Bureau Web site: Available at http://www.ngb.army.mil/default. aspx.). The National Guard (NG) is a constitutionally unique organization (United States Constitution, US Government Printing Office Web site: Available at http://www.gpoaccess.gov/constitution/index.html.). Today's Guard conducts domestic disaster response and civilian assistance missions on a daily basis. Yet, the NG's role, mission, and capabilities are not well-known or understood. The National Response Framework (NRF) places significant responsibility on the local and state disaster planners (Department of Homeland Security: National Response Framework. US Department of Homeland Security, Washington, DC, January 2008). The public health professionals are an integral component of the disaster planning community. It is critical that the public health community be knowledgeable of types and capabilities of all the response assets at their disposal.

  3. “We Routinely Borrow to Survive”: Exploring the Financial Capability of Income-Poor People in India.

    Science.gov (United States)

    Banerjee, Mahasweta M

    2016-10-01

    A lack of financial capability—financial opportunities and abilities—and poverty are highly interlinked. Over 65 percent of people in India are excluded from any financial services. This article explores income-poor Indians’ experiences with financial capability through a qualitative study. Purposive sampling was used to collect data from 658 individuals, through focus groups (n = 566) and face-to-face interviews (n = 92). Findings show that 97 percent of respondents had the opportunity to earn an income, and 55 percent earned through financial inclusion programs, but 87 percent of respondents earned less than U.S. $2 a day. Although almost all saved and needed to borrow, 46 percent were eligible for formal savings and only 23 percent for formal loans. Financial abilities or knowledge and skills related to income, savings, and loans were higher among the few who had a stable income or had medium and high income in relation to those who had unstable and low income. Respondents experienced many challenges with their financial capabilities, including borrowing to save, fearing formal loans, and lacking clarity about loan and interest rate; banks miscalculating interest rates; and political parties influencing access to loans. Implications for social policy and social work practice are discussed.

  4. Establishing a Research and Evaluation Capability for the Joint Medical Education and Training Campus.

    Science.gov (United States)

    Kirby, Sheila Nataraj; Marsh, Julie A; Thie, Harry J

    2011-01-01

    In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organization and to seek accreditation as a community college. Such goals require a clear model of organizational improvement with well-defined metrics for measuring its performance and using research and evaluation to assess and improve that performance. Lessons learned from a review of practices at institutions with similar missions-such as community colleges, corporate universities, the UK's Defence Medical Education and Training Agency, and other federal agencies, such as the Veterans Health Administration-establish a clear need for an office of institutional research to help METC attain its organizational goals. They also provide useful recommendations regarding the METC office's structure, scope, and governance.

  5. Exploring the Influence of Context on Feedback at Medical School: A Video-Ethnography Study

    Science.gov (United States)

    Urquhart, L. M.; Ker, J. S.; Rees, C. E.

    2018-01-01

    Feedback in medical education is complicated by the multiple contexts within which learning occurs. However, feedback research in medical education has typically focused on information provided by tutors to students with limited exploration of the influence of context. This research seeks to address this gap by exploring the influence of multiple…

  6. General practitioners' decisions about discontinuation of medication: an explorative study.

    Science.gov (United States)

    Nixon, Michael Simon; Vendelø, Morten Thanning

    2016-06-20

    Purpose - The purpose of this paper is to investigate how general practitioners' (GPs) decisions about discontinuation of medication are influenced by their institutional context. Design/methodology/approach - In total, 24 GPs were interviewed, three practices were observed and documents were collected. The Gioia methodology was used to analyse data, drawing on a theoretical framework that integrate the sensemaking perspective and institutional theory. Findings - Most GPs, who actively consider discontinuation, are reluctant to discontinue medication, because the safest course of action for GPs is to continue prescriptions, rather than discontinue them. The authors conclude that this is in part due to the ambiguity about the appropriateness of discontinuing medication, experienced by the GPs, and in part because the clinical guidelines do not encourage discontinuation of medication, as they offer GPs a weak frame for discontinuation. Three reasons for this are identified: the guidelines provide dominating triggers for prescribing, they provide weak priming for discontinuation as an option, and they underscore a cognitive constraint against discontinuation. Originality/value - The analysis offers new insights about decision making when discontinuing medication. It also offers one of the first examinations of how the institutional context embedding GPs influences their decisions about discontinuation. For policymakers interested in the discontinuation of medication, the findings suggest that de-stigmatising discontinuation on an institutional level may be beneficial, allowing GPs to better justify discontinuation in light of the ambiguity they experience.

  7. An Exploration of the Benefits of an Animallike Robot Companion with More Advanced Touch Interaction Capabilities for Dementia Care

    Directory of Open Access Journals (Sweden)

    Merel M. Jung

    2017-06-01

    Full Text Available Animallike robot companions such as robotic seal Paro are increasingly used in dementia care due to the positive effects that interaction with these robots can have on the well-being of these patients. Touch is one of the most important interaction modalities for patients with dementia and can be a natural way to interact with animallike robots. To advance the development of animallike robots, we explored in what ways people with dementia could benefit from interaction with an animallike robot with more advanced touch recognition capabilities and which touch gestures would be important in their interaction with Paro. In addition, we explored which other target groups might benefit from interaction with animallike robots with more advanced interaction capabilities. In this study, we administered a questionnaire and conducted interviews with two groups of health-care providers who all worked in a geriatric psychiatry department. One group used Paro in their work (i.e., the expert group; n = 5 while the other group had no experience with the use of animallike robot (i.e., the layman group; n = 4. The results showed that health-care providers perceived Paro as an effective intervention to improve the well-being of people with dementia. Examples of usages for Paro that were mentioned were providing distraction, interrupting problematic behaviors, and stimulating communication. Furthermore, the care providers indicated that people with dementia (would use mostly positive forms of touch and speech to interact with Paro. Paro’s auditory responses were criticized because they can overstimulate the patients. In addition, the care providers argued that social interactions with Paro are currently limited and therefore the robot does not meet the needs of a broader audience such as healthy elderly people who still live in their own homes. The development of robot pets with more advanced social capabilities such as touch and speech recognition might

  8. Exploring the situational motivation of medical specialists: a qualitative study.

    Science.gov (United States)

    van der Burgt, Stéphanie M E; Kusurkar, Rashmi A; Croiset, Gerda; Peerdeman, Saskia M

    2018-02-26

    The aim was to obtain insight into the factors in the work environment that motivate or demotivate a medical specialist during his/her working day. A qualitative ethnographic design was used, and a constructivist approach was adopted with the Self-Determination theory of motivation as a framework. Six medical specialists from VU University Medical Center in the Netherlands, recruited through convenience, snowball, and purposive sampling, were shadowed for one day each. Data were transcribed and open-coded. Themes were finalized through discussion and consensus. Sixty hours of observation data identified motivating and demotivating factors categorized into four themes that are important for specialists' motivation. Informational technology issues are demotivating factors. Working with colleagues can be both a motivating and demotivating factor, e.g., filling in for each other through feelings of relatedness was motivating. Being in control of one's planning through feelings of autonomy was motivating. Furthermore, patient care and teaching, especially in combination, stimulated specialists' motivation. Regarding the design of the study, we found that situational motivation is indeed observable. The basic psychological needs autonomy, competence, and relatedness are important for specialists' motivation. Investing in a more motivating, open, transparent, and basic-needs- supportive work environment for medical specialists is necessary. Keywords: Continuing professional development, motivation, medical specialists, self-determination theory, qualitative research.

  9. Exploration of Global Health Careers Across the Medical Fields.

    Science.gov (United States)

    Barthélemy, Ernest; Mallol, Vanessa; Hannaford, Alisse; Pean, Christian; Kutua, Rehema; de Haydu, Christopher; Anandaraja, Natasha; Asgary, Ramin; Elahi, Ebrahim; Hexom, Braden; Landrigan, Philip; Shirazian, Taraneh; Katz, Craig

    Despite expansion of interest among American medical students in global health (GH), academic medical centers face multiple obstacles to the development of structured GH curricula and career guidance. To meet these demands we sought to provide a systematic analysis of the accounts of GH experts. We developed a collaborative, interview-based, qualitative analysis of GH experiences across six career-related themes that are relevant to medical students interested in GH: justification, medical education, economics, research prospects, law and ethics, and work-life balance. Seven GH faculty members were interviewed for 30-90 minutes using sample questions as guidelines. We applied a grounded theory approach to analyze the interview transcripts to discover an emerging theory pertinent to GH trainees. Regarding justification, 4 respondents defined GH as work with the underserved irrespective of geographic location; 5 respondents found sustainability imperative; and all respondents believe GH creates better physicians. Respondents identified many physician competencies developed through GH medical education, with 5 respondents agreeing that work with underserved populations has transformative potential. Concerning economics, 3 respondents acknowledged GH's popularity among trainees, resulting in increased training opportunities, and 2 respondents emphasized an associated deficiency in program quality. All respondents described career models across specialties. Four respondents noted funding challenges when discussing research prospects. Within the theme of laws and ethics, 4 respondents perceived inadequate accountability, and 6 respondents identified ways to create accountability. Finally, 6 respondents recognized family demands can compromise one's GH career and thus work-life balance. Despite diverse perspectives on the meaning and sustainability of GH work, this analysis provides a nascent framework that may inform curricular development for GH trainees. Suggestions

  10. Exploring the experiences and coping strategies of international medical students

    Directory of Open Access Journals (Sweden)

    Malau-Aduli Bunmi S

    2011-06-01

    Full Text Available Abstract Background Few studies have addressed the challenges that international medical students face and there is a dearth of information on the behavioural strategies these students adopt to successfully progress through their academic program in the face of substantial difficulties of language barrier, curriculum overload, financial constraints and assessment tasks that require high proficiency in communication skills. Methods This study was designed primarily with the aim of enhancing understanding of the coping strategies, skill perceptions and knowledge of assessment expectations of international students as they progress through the third and fourth years of their medical degree at the School of Medicine, University of Tasmania, Australia. Results Survey, focus group discussion and individual interviews revealed that language barriers, communication skills, cultural differences, financial burdens, heavy workloads and discriminatory bottlenecks were key factors that hindered their adaptation to the Australian culture. Quantitative analyses of their examination results showed that there were highly significant (p Conclusions Despite the challenges, these students have adopted commendable coping strategies and progressed through the course largely due to their high sense of responsibility towards their family, their focus on the goal of graduating as medical doctors and their support networks. It was concluded that faculty needs to provide both academic and moral support to their international medical students at three major intervention points, namely point of entry, mid way through the course and at the end of the course to enhance their coping skills and academic progression. Finally, appropriate recommendations were made.

  11. Becoming an Educational Leader--Exploring Leadership in Medical Education

    Science.gov (United States)

    Bolander Laksov, Klara; Tomson, Tanja

    2017-01-01

    Research on educational leadership emphasizes the importance of having institutional leaders heavily involved with advanced instructional programming. Best practices for developing educational leadership in higher education health care and medical faculties have to be better understood. Within the framework of a seminar series, researchers and…

  12. An exploration into the awareness and perceptions of medical ...

    African Journals Online (AJOL)

    factors in a multicultural society influence the consultation, and to suggest adaptations for teaching. Methods. Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. Some of the students had viewed a video of a consultation with an isiZulu-speaking patient, and completed ...

  13. Behavioral Exploration of Career and Specialty Choice in Medical Students

    Science.gov (United States)

    Borges, Nicole J.

    2007-01-01

    Understanding the process by which students naturally construct and internalize their educational experiences relating to career development is important to career counseling. The author investigated how exploratory behaviors during a community-based field experience course contributed to the vocational development of 1st-year medical students.…

  14. An exploration into the awareness and perceptions of medical ...

    African Journals Online (AJOL)

    effect on how patients present to healthcare providers.[1] Such ... Focus group discussions were conducted with final-year medical students in the Family Medicine rotation. ... and patients in cross-cultural consultations, the potential knowledge and experience gap that exists across cultures, and an awareness of the need for.

  15. Exploring Jahrom Medical University students' attitudes towards the ...

    African Journals Online (AJOL)

    Introduction: Self- evaluation is the process of designing, building and maintaining human behaviors that can lead to maturity and perfection. Therefore, the aim of this study is to examine Jahrom Medical University students' attitudes towards the Islamic self-assessment in 2015. Method: This cross-sectional and descriptive ...

  16. Polymeric Medical Sutures: An Exploration of Polymers and Green Chemistry

    Science.gov (United States)

    Knutson, Cassandra M.; Schneiderman, Deborah K.; Yu, Ming; Javner, Cassidy H.; Distefano, Mark D.; Wissinger, Jane E.

    2017-01-01

    With new K-12 national science standards emerging, there is an increased need for experiments that integrate engineering into the context of society. Here we describe a chemistry experiment that combines science and engineering principles while introducing basic polymer and green chemistry concepts. Using medical sutures as a platform for…

  17. An explorative study of school performance and antipsychotic medication

    NARCIS (Netherlands)

    van der Schans, J.; Vardar, S; Cicek, R.; Bos, H. J.; Hoekstra, P. J.; de Vries, T. W.; Hak, E.

    2016-01-01

    Background: Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. Methods:

  18. Medical and technology requirements for human solar system exploration missions

    Science.gov (United States)

    Nicogossian, Arnauld; Harris, Leonard; Couch, Lana; Sulzman, Frank; Gaiser, Karen

    1989-01-01

    Measures that need to be taken to cope with the health problems posed by zero gravity and radiation in manned solar system exploration missions are discussed. The particular systems that will be used aboard Space Station Freedom are addressed, and relevant human factors problems are examined. The development of a controlled ecological life support system is addressed.

  19. Explore and experience: mobile augmented reality for medical training.

    Science.gov (United States)

    Albrecht, Urs-Vito; Noll, Christoph; von Jan, Ute

    2013-01-01

    In medicine, especially in basic education, it may sometimes be inappropriate to integrate real patients into classes due to ethical issues that must be avoided. Nevertheless, the quality of medical education may suffer without the use of real cases. This is especially true of medical specialties such as legal medicine: survivors of a crime are already subjected to procedures that constitute a severe emotional burden and may cause additional distress even without the added presence of students. Using augmented reality based applications may alleviate this ethical dilemma by giving students the possibility to practice the necessary skills based on virtual but nevertheless almost realistic cases. The app "mARble®" that is presented in this paper follows this approach. The currently available learning module for legal medicine gives users an opportunity to learn about various wound patterns by virtually overlaying them on their own skin and is applicable in different learning settings. Preliminary evaluation results covering learning efficiency and emotional components of the learning process are promising. Content modules for other medical specialtiesare currently under construction.

  20. The Space Launch System -The Biggest, Most Capable Rocket Ever Built, for Entirely New Human Exploration Missions Beyond Earth's Orbit

    Science.gov (United States)

    Shivers, C. Herb

    2012-01-01

    NASA is developing the Space Launch System -- an advanced heavy-lift launch vehicle that will provide an entirely new capability for human exploration beyond Earth's orbit. The Space Launch System will provide a safe, affordable and sustainable means of reaching beyond our current limits and opening up new discoveries from the unique vantage point of space. The first developmental flight, or mission, is targeted for the end of 2017. The Space Launch System, or SLS, will be designed to carry the Orion Multi-Purpose Crew Vehicle, as well as important cargo, equipment and science experiments to Earth's orbit and destinations beyond. Additionally, the SLS will serve as a backup for commercial and international partner transportation services to the International Space Station. The SLS rocket will incorporate technological investments from the Space Shuttle Program and the Constellation Program in order to take advantage of proven hardware and cutting-edge tooling and manufacturing technology that will significantly reduce development and operations costs. The rocket will use a liquid hydrogen and liquid oxygen propulsion system, which will include the RS-25D/E from the Space Shuttle Program for the core stage and the J-2X engine for the upper stage. SLS will also use solid rocket boosters for the initial development flights, while follow-on boosters will be competed based on performance requirements and affordability considerations.

  1. Exploring the Mediation Between KM Infrastructure Capabilities and Organisational Performance: The Penetration of Learning by KM Practices

    OpenAIRE

    Meng-Lin Shih; Shu-Hui Chuang; Chechen Liao

    2009-01-01

    Previous studies have examined the relationship between knowledge management (KM) infrastructure capabilities and organisational performance. However, most studies neglect the mediating effect of organisational learning by KM practices (OLKMP) in the relationship between KM infrastructure capabilities and organisational performance. This study uses the survey method to discuss the relationships governing KM infrastructure capabilities, OLKMP and organisational performance. Results of the anal...

  2. Storyboard for the Medical System Concept of Operations for Mars Exploration Missions

    Science.gov (United States)

    Antonsen, Eric; Hailey, Melinda; Reyes, David; Rubin, David; Urbina, Michelle

    2017-01-01

    This storyboard conceptualizes one scenario of an integrated medical system during a Mars exploration mission. All content is for illustrative purposes only and neither defines nor implies system design requirement.

  3. An explorative study of school performance and antipsychotic medication.

    Science.gov (United States)

    van der Schans, J; Vardar, S; Çiçek, R; Bos, H J; Hoekstra, P J; de Vries, T W; Hak, E

    2016-09-21

    Antipsychotic therapy can reduce severe symptoms of psychiatric disorders, however, data on school performance among children on such treatment are lacking. The objective was to explore school performance among children using antipsychotic drugs at the end of primary education. A cross-sectional study was conducted using the University Groningen pharmacy database linked to academic achievement scores at the end of primary school (Dutch Cito-test) obtained from Statistics Netherlands. Mean Cito-test scores and standard deviations were obtained for children on antipsychotic therapy and reference children, and statistically compared using analyses of covariance. In addition, differences in subgroups as boys versus girls, ethnicity, household income, and late starters (start date within 12 months of the Cito-test) versus early starters (start date > 12 months before the Cito-test) were tested. In all, data from 7994 children could be linked to Cito-test scores. At the time of the Cito-test, 45 (0.6 %) were on treatment with antipsychotics. Children using antipsychotics scored on average 3.6 points lower than the reference peer group (534.5 ± 9.5). Scores were different across gender and levels of household income (p starters were significantly higher than starters within 12 months (533.7 ± 1.7 vs. 524.1 ± 2.6). This first exploration showed that children on antipsychotic treatment have lower school performance compared to the reference peer group at the end of primary school. This was most noticeable for girls, but early starters were less affected than later starters. Due to the observational cross-sectional nature of this study, no causality can be inferred, but the results indicate that school performance should be closely monitored and causes of underperformance despite treatment warrants more research.

  4. [Exploring the dark continent: medical image and brain].

    Science.gov (United States)

    Garcia-Molina, A; Ensenat, A

    2017-04-01

    Until the late 19th century, direct observation of the central nervous system was practically impossible. The discovery of X-rays in 1895 and their subsequent application in the field of medicine brought about a shift of paradigm that completely revolutionised the way in which neurology was practised. The possibility of viewing the inside of the brain had a pronounced impact on clinical practice, and enriched the diagnosis and treatment of brain pathologies in a manner that was unimaginable up until then. The aim of this study is to describe the birth and development of medical imaging of the brain, from the discovery of X-rays and the early days of radiography to the appearance of computerised tomography and magnetic resonance in the 60s, both of which are techniques that were to change the world of diagnostic imaging forever. This brief overview of the history of radiology also includes the origins of angiography and other techniques that are no longer in use, but which were ground-breaking innovations in their time, such as ventriculography or pneumoencephalography. The procedures and techniques described in this article made it possible to view the inside of the brain, thereby facilitating the diagnosis and treatment of a number of neurological processes.

  5. Taiwanese Medical Students' Narratives of Intercultural Professionalism Dilemmas: Exploring Tensions between Western Medicine and Taiwanese Culture

    Science.gov (United States)

    Ho, Ming-Jung; Gosselin, Katherine; Chandratilake, Madawa; Monrouxe, Lynn V.; Rees, Charlotte E.

    2017-01-01

    In an era of globalization, cultural competence is necessary for the provision of quality healthcare. Although this topic has been well explored in non-Western cultures within Western contexts, the authors explore how Taiwanese medical students trained in Western medicine address intercultural professionalism dilemmas related to tensions between…

  6. [Exploration and analysis of the thought of medical education in the Shanghai New Chinese Medical College].

    Science.gov (United States)

    Li, Ming; Shang, Li; Bing, Shoulan

    2014-11-01

    Shanghai New Chinese Medical College set up by Zhu Nanshan and his sons, Zhu Xiaonan and Zhu Hegao, was a medical college of traditional Chinese medicine (TCM) with the most innovative spirit in modern time. Its affiliated research institute held the principle of "realizing the scientific truth of TCM, training TCM advanced talents", marking the beginning of the pioneering of "scientific TCM". The educational plan, clinical research and academic organization based on "carrying forward the quintessence of Chinese culture, absorbing and digesting the new knowledge" showed a certain influence at home and abroad. The College advocated the combination of communicating with famous physicians and the study of theory, cultivation of students' organization and academic society, launching of journals, and organizing students' research associations was aiming at the satisfaction of the social needs and teaching orientation. Its running experience provided useful reference for modern TCM medical education.

  7. Medical students' note-taking in a medical biochemistry course: an initial exploration.

    Science.gov (United States)

    Morrison, Elizabeth H; McLaughlin, Calvin; Rucker, Lloyd

    2002-04-01

    Beginning medical students spend numerous hours every week attending basic science lectures and taking notes. Medical faculty often wonder whether they should give students pre-printed instructors' notes before lectures. Proponents of this strategy argue that provided notes enhance learning by facilitating the accurate transmission of information, while opponents counter that provided notes inhibit students' cognitive processing or even discourage students from attending lectures. Little if any research has directly addressed medical students' note-taking or the value of providing instructors' notes. The educational literature does suggest that taking lecture notes enhances university students' learning. University students perform best on post-lecture testing if they review a combination of provided notes and their own personal notes, particularly if the provided notes follow a 'skeletal' format that encourages active note-taking.

  8. Leadership and followership in the healthcare workplace: exploring medical trainees' experiences through narrative inquiry

    OpenAIRE

    Gordon, Lisi J.; Rees, Charlotte E.; Ker, Jean S.; Cleland, Jennifer

    2015-01-01

    This research was part of LJG’s PhD research which was generously funded by NHS Education for Scotland through SMERC. OBJECTIVES: To explore medical trainees' experiences of leadership and followership in the interprofessional healthcare workplace. DESIGN: A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. SETTING: Multisite study across four UK health boards. PARTICIPANTS: Through maximum variation sampling, 65...

  9. Missile Defense in the 21st Century Acquisition Environment: Exploring a BMD-Capable LCS Mission Package

    Science.gov (United States)

    2013-09-01

    BDA ) to the operator REQ.1.2.3 The system shall provide post mission data at the end of mission REQ.1.2.4 The system shall has the capability...sheet 6 — The beaufort scale. Retrieved from National Meteorological Library and Archive: http://www.metoffice.gov.uk/ media /pdf/b/7/Fact_sheet_No._6

  10. A qualitative study exploring issues related to medication management in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Ahmad Nizaruddin M

    2017-11-01

    Full Text Available Mariani Ahmad Nizaruddin, Marhanis-Salihah Omar, Adliah Mhd-Ali, Mohd Makmor-Bakry Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Background: Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs.Participants and methods: A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner.Results and discussion: Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents’ medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes.Conclusion: There are important issues

  11. A qualitative study exploring issues related to medication management in residential aged care facilities.

    Science.gov (United States)

    Ahmad Nizaruddin, Mariani; Omar, Marhanis-Salihah; Mhd-Ali, Adliah; Makmor-Bakry, Mohd

    2017-01-01

    Globally, the population of older people is on the rise. As families are burdened with the high cost of care for aging members, demand is increasing for medical care and nursing homes. Thus, medication management is crucial to ensure that residents in a care center benefit and assist the management of the care center in reducing the burden of health care. This study is aimed to qualitatively explore issues related to medication management in residential aged care facilities (RACFs). A total of 11 stakeholders comprising health care providers, administrators, caretakers and residents were recruited from a list of registered government, nongovernmental organization and private RACFs in Malaysia from September 2016 to April 2017. An exploratory qualitative study adhering to Consolidated Criteria for Reporting Qualitative Studies was conducted. In-depth interview was conducted with consent of all participants, and the interviews were audio recorded for later verbatim transcription. Observational analysis was also conducted in a noninterfering manner. Three themes, namely medication use process, personnel handling medications and culture, emerged in this study. Medication use process highlighted an unclaimed liability for residents' medication by the RACFs, whereas personnel handling medications were found to lack sufficient training in medication management. Culture of the organization did affect the medication safety and quality improvement. The empowerment of the residents in their medication management was limited. There were unclear roles and responsibility of who manages the medication in the nongovernment-funded RACFs, although they were well structured in the private nursing homes. There are important issues related to medication management in RACFs which require a need to establish policy and guidelines.

  12. Trend of Medical Tourism Publications: An Attempt to Explore the Involved Academic Disciplines and Interests.

    Science.gov (United States)

    Rokni, Ladan; Park, Sam-Hun

    2018-02-01

    Medical tourism suffers from the lack of a consensus regarding the involved categories. This study aimed to address this gap from the academic disciplines and publications perspective. Totally 1954 citations were identified through a formula of keyword search of SCOPUS. In order to classify the various subject areas, we followed the international standard classification of education (ISCED) developed by UNESCO. Moreover, the trends of publications were identified based on their popularity between 2000 and 2017. The category with the most interests on publication about medical tourism was 'health and welfare', followed by 'social science'. Even though various disciplines were involved in the medical tourism, it seems that a downward trend has been experienced since 2015. The identified key trends of medical tourism publications will benefit researchers exploring the categories of medical tourism or health travel. The results contribute to advance the state of knowledge from the academic perspective.

  13. Exploring the potential of video technologies for collaboration in emergency medical care

    DEFF Research Database (Denmark)

    Söderholm, Hanna M.; Sonnenwald, Diane H.; Manning, James E.

    2008-01-01

    conferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The experimental design and results concerning information behavior are presented in the article "Exploring the Potential of Video...

  14. Early assessment of medical devices in development for company decision making : An exploration of best practices

    NARCIS (Netherlands)

    Markiewicz, Katarzyna; Van Til, Janine; IJzerman, Maarten

    2017-01-01

    To improve successful development and clinical use of medical technologies, it is suggested that manufacturers should start collecting evidence on devices effectiveness and eficiency early in their development. The aim of this study was to explore whether and how Dutch manufacturers perform an early

  15. Exploring factors affecting undergraduate medical students' study strategies in the clinical years: a qualitative study.

    NARCIS (Netherlands)

    Al Kadri, H.M.; Al-Moamary, M.S.; Elzubair, M.; Magzoub, M.E.; AlMutairi, A.; Roberts, C.; Vleuten, C.P.M. van der

    2011-01-01

    The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health

  16. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study.

    Science.gov (United States)

    Smeulers, Marian; Onderwater, Astrid T; van Zwieten, Myra C B; Vermeulen, Hester

    2014-04-01

    To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative interview study of 20 nurses in an academic medical centre was conducted between March and December of 2011. Three themes emerged from this study: (1) nurses' roles and responsibilities in medication safety: aside from safe preparation and administration, the clinical reasoning of nurses is essential for medication safety; (2) nurses' ability to work safely: knowledge of risks and nurses' work circumstances influence their ability to work safely; and (3) nurses' acceptance of safety practices: advantages, feasibility and appropriateness are important incentives for acceptance of a safety practice. Nurses' experiences coincide with the assumption that they are in a pre-eminent position to enable safe medication management; however, their ability to adequately perform this role depends on sufficient knowledge to assess the risks of medication administration and on the circumstances in which they work. Safe medication management requires a learning climate and professional practice environment that enables further development of professional nursing skills and knowledge. © 2014 John Wiley & Sons Ltd.

  17. Medical migration: A qualitative exploration of the atypical path of Japanese international medical graduates.

    Science.gov (United States)

    Heist, Brian S; Torok, Haruka Matsubara

    2018-01-01

    International Medical Graduates (IMGs) are commonly understood to move from low to high resource countries with motivations including improved financial situations and cultures of emigration. A presumable exception to the above themes would be the Japanese IMG population. The aim of this study was to develop an understanding of the Japanese IMG experience. Using a grounded theory approach, we interviewed 19 Japanese IMGs working in the US and 16 Japanese IMGs working in Japan who had completed US clinical training. Questions addressed decision-making to pursue US clinical training, goals for the training, and career decision-making upon completing the training. Data collection and constant comparative analysis were conducted iteratively to identify emerging themes. The emerging model of the Japanese IMG experience is focused around pivotal experiences that often include dissatisfaction with the quality of Japanese clinical training and personal exposures to US clinical education. Further decision-making in the pursuit of US residency is influenced by educator training quality, and clinical training and career opportunities. The desire to improve Japanese clinical training commonly influences career decision-making after US training. The Japanese IMG experience contrasts numerous perceptions of international physician migration and, in turn, enhances understanding of this paradigm.

  18. Exploring the Value of the Capability Approach for Vocational Education and Training Evaluation: Reflections from South Africa

    Directory of Open Access Journals (Sweden)

    Lesley Powell

    2014-11-01

    Full Text Available In the late 1990s, South Africa faced the three-fold challenge of reforming the apartheid-divided institutional landscape of vocational education and training (VET institutions; ensuring equitable access to skills; and reorienting its skills development system in line with the nation’s reinsertion into the global economy. A wave of institutional reforms was enacted which was followed by a large programme of evaluative research. While this body of work was both valuable and necessary, it nonetheless had several limitations. As part of efforts to overcome these, the authors suggest an alternative evaluation method that draws on insights from the ‘capability approach’. By putting the needs of people first – rather than the needs of the economy – the capability approach emphasises social justice, human rights and poverty alleviation in VET evaluation. This approach is more focused on the values and goals of individuals and institutions, while retaining the economic rationale as a key analytical tool and emphasising the continued importance of evaluation for the improvement of delivery and outcomes.

  19. Direct transport to a PCI-capable hospital is associated with improved survival after adult out-of-hospital cardiac arrest of medical aetiology.

    Science.gov (United States)

    McKenzie, Nicole; Williams, Teresa A; Ho, Kwok M; Inoue, Madoka; Bailey, Paul; Celenza, Antonio; Fatovich, Daniel; Jenkins, Ian; Finn, Judith

    2018-05-02

    To compare survival outcomes of adults with out-of-hospital cardiac arrest (OHCA) of medical aetiology directly transported to a percutaneous-coronary-intervention capable (PCI-capable) hospital (direct transport) with patients transferred to a PCI-capable hospital via another hospital without PCI services available (indirect transport) by emergency medical services (EMS). This retrospective cohort study used the St John Ambulance Western Australia OHCA Database and medical chart review. We included OHCA patients (≥18 years) admitted to any one of five PCI-capable hospitals in Perth between January 2012 and December 2015. Survival to hospital discharge (STHD) and survival up to 12-months after OHCA were compared between the direct and indirect transport groups using multivariable logistic and Cox-proportional hazards regression, respectively, while adjusting for so-called "Utstein variables" and other potential confounders. Of the 509 included patients, 404 (79.4%) were directly transported to a PCI-capable hospital and 105 (20.6%) transferred via another hospital to a PCI-capable hospital; 274/509 (53.8%) patients STHD and 253/509 (49.7%) survived to 12-months after OHCA. Direct transport patients were twice as likely to STHD (adjusted odds ratio 1.97, 95% confidence interval [CI] 1.13-3.43) than those transferred via another hospital. Indirect transport was also associated with a possible increased risk of death, up to 12-months, compared to direct transport (adjusted hazard ratio 1.36, 95% CI 1.00-1.84). Direct transport to a PCI-capable hospital for post-resuscitation care is associated with a survival advantage for adults with OHCA of medical aetiology. This has implications for EMS transport protocols for patients with OHCA. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Predictive Psychiatric Genetic Testing in Minors: An Exploration of the Non-Medical Benefits.

    Science.gov (United States)

    Manzini, Arianna; Vears, Danya F

    2018-03-01

    Predictive genetic testing for susceptibility to psychiatric conditions is likely to become part of standard practice. Because the onset of most psychiatric diseases is in late adolescence or early adulthood, testing minors could lead to early identification that may prevent or delay the development of these disorders. However, due to their complex aetiology, psychiatric genetic testing does not provide the immediate medical benefits that current guidelines require for testing minors. While several authors have argued non-medical benefits may play a crucial role in favour of predictive testing for other conditions, little research has explored such a role in psychiatric disorders. This paper outlines the potential non-medical benefits and harms of psychiatric genetic testing in minors in order to consider whether the non-medical benefits could ever make such testing appropriate. Five non-medical themes arise in the literature: psychological impacts, autonomy/self-determination, implications of the biomedical approach, use of financial and intellectual resources, and discrimination. Non-medical benefits were prominent in all of them, suggesting that psychiatric genetic testing in minors may be appropriate in some circumstances. Further research needs to empirically assess these potential non-medical benefits, incorporate minors in the debate, and include normative reflection to evaluate the very purposes and motivations of psychiatric genetic testing in minors.

  1. Does a summative portfolio foster the development of capabilities such as reflective practice and understanding ethics? An evaluation from two medical schools.

    Science.gov (United States)

    O'Sullivan, Anthony J; Howe, Amanda C; Miles, Susan; Harris, Peter; Hughes, Chris S; Jones, Philip; Scicluna, Helen; Leinster, Sam J

    2012-01-01

    Portfolios need to be evaluated to determine whether they encourage students to develop in capabilities such as reflective practice and ethical judgment. The aims of this study were (i) to determine whether preparing a portfolio helps promote students' development in a range of capabilities including understanding ethical and legal principles, reflective practice and effective communication, and (ii) to determine to what extent the format of the portfolio affected the outcome by comparing the experiences of students at two different medical schools. A questionnaire was designed to evaluate undergraduate medical students' experiences of completing a portfolio at two medical schools. A total of 526 (45% response rate) students answered the on-line questionnaire. Students from both medical schools gave the highest ranking for the portfolio as a trigger for reflective practice. 63% of students agreed their portfolio helped them develop reflective practice skills (p portfolios helped them understand ethical and legal principles whereas 29% disagreed (p portfolio helped them to develop effective communication. Students perceive portfolio preparation as an effective learning tool for the development of capabilities such as understanding ethical and legal principles and reflective practice, whereas other capabilities such as effective communication require complementary techniques and other modes of assessment.

  2. Exploring the association between parental rearing styles and medical students' critical thinking disposition in China.

    Science.gov (United States)

    Huang, Lei; Wang, Zhaoxin; Yao, Yuhong; Shan, Chang; Wang, Haojie; Zhu, Mengyi; Lu, Yuan; Sun, Pengfei; Zhao, Xudong

    2015-05-14

    Critical thinking is an essential ability for medical students. However, the relationship between parental rearing styles and medical students' critical thinking disposition has rarely been considered. The aim of this study was to investigate whether parental rearing styles were significant predictors of critical thinking disposition among Chinese medical students. 1,075 medical students from the first year to the fifth year attending one of three medical schools in China were recruited via multistage stratified cluster sampling. The Chinese Critical Thinking Disposition Inventory(CTDI-CV) and The Egna Minnen av Barndoms Uppfostran (EMBU) questionnaire were applied to collect data and to conduct descriptive analysis. Stepwise multiple linear regression was used to analyze the data. The critical thinking disposition average mean score was 287.44 with 632 participants (58.79%) demonstrating positive critical thinking disposition. Stepwise multiple linear regression analysis revealed that the rearing styles of fathers, including "overprotection", "emotional warmth and understanding", "rejection" and "over-interference" were significant predictors of medical students' critical thinking disposition that explained 79.0% of the variance in critical thinking ability. Rearing styles of mothers including "emotional warmth and understanding", "punishing" and "rejection" were also found to be significant predictors, and explained 77.0% of the variance. Meaningful association has been evidenced between parental rearing styles and Chinese medical students' critical thinking disposition. Parental rearing styles should be considered as one of the many potential determinant factors that contribute to the cultivation of medical students' critical thinking capability. Positive parental rearing styles should be encouraged in the cultivation of children's critical thinking skills.

  3. Design study of nuclear power systems for deep space explorers. (2) Electricity supply capabilities of solid cores

    International Nuclear Information System (INIS)

    Yamaji, Akifumi; Takizuka, Takakazu; Nabeshima, Kunihiko; Iwamura, Takamichi; Akimoto, Hajime

    2009-01-01

    This study has been carried out in series with the other study, 'Criticality of Low Enriched Uranium Fueled Core' to explore the possibilities of a solid reactor electricity generation system for supplying propulsion power of a deep space explorer. The design ranges of two different systems are determined with respect to the electric power, the radiator mass, and the operating temperatures of the heat-pipes and thermoelectric converters. The two systems are the core surface cooling with heat-pipe system (CSHP), and the core direct cooling with heat-pipe system (CDHP). The evaluated electric powers widely cover the 1 to 100 kW range, which had long been claimed to be the range that lacked the power sources in space. Therefore, the concepts shown by this study may lead to a breakthrough of the human activities in space. The working temperature ranges of the main components, namely the heat-pipes and thermoelectric converters, are wide and covers down to relatively low temperatures. This is desirable from the viewpoints of broadening the choices, reducing the development needs, and improving the reliabilities of the devices. Hence, it is advantageous for an early establishment of the concept. (author)

  4. Antarctic Exploration Parallels for Future Human Planetary Exploration: Science Operations Lessons Learned, Planning, and Equipment Capabilities for Long Range, Long Duration Traverses

    Science.gov (United States)

    Hoffman, Stephen J.

    2012-01-01

    The purpose for this workshop can be summed up by the question: Are there relevant analogs to planetary (meaning the Moon and Mars) to be found in polar exploration on Earth? The answer in my opinion is yes or else there would be no reason for this workshop. However, I think some background information would be useful to provide a context for my opinion on this matter. As all of you are probably aware, NASA has been set on a path that, in its current form, will eventually lead to putting human crews on the surface of the Moon and Mars for extended (months to years) in duration. For the past 50 V 60 years, starting not long after the end of World War II, exploration of the Antarctic has accumulated a significant body of experience that is highly analogous to our anticipated activities on the Moon and Mars. This relevant experience base includes: h Long duration (1 year and 2 year) continuous deployments by single crews, h Established a substantial outpost with a single deployment event to support these crews, h Carried out long distance (100 to 1000 kilometer) traverses, with and without intermediate support h Equipment and processes evolved based on lessons learned h International cooperative missions This is not a new or original thought; many people within NASA, including the most recent two NASA Administrators, have commented on the recognizable parallels between exploration in the Antarctic and on the Moon or Mars. But given that level of recognition, relatively little has been done, that I am aware of, to encourage these two exploration communities to collaborate in a significant way. [Slide 4] I will return to NASA s plans and the parallels with Antarctic traverses in a moment, but I want to spend a moment to explain the objective of this workshop and the anticipated products. We have two full days set aside for this workshop. This first day will be taken up with a series of presentations prepared by individuals with experience that extends back as far as the

  5. Educational Debt in the Context of Career Planning: A Qualitative Exploration of Medical Student Perceptions.

    Science.gov (United States)

    Phillips, Julie P; Wilbanks, Deana M; Salinas, Diana F; Doberneck, Diane M

    2016-01-01

    Phenomenon: Medical students in the United States face increasing educational debt because medical education costs have risen while public investment in higher education has declined. Contemporary students borrow more money and accumulate debt far surpassing that of previous generations of physicians, and both interest rates and terms of loan repayment have changed significantly in the last decade. As a result, the experiences of medical students differ from the experiences of physician educators. Little is known about how contemporary medical students view their debt in the context of career planning. Understanding contemporary U.S. medical students' lived experiences of educational debt is important, because high debt levels may affect medical students' well-being and professional development. The study's purpose was to explore contemporary students' views of their debt in the context of career planning. In 2012, 2nd-year medical students enrolled in a health policy course at one medical school were invited to write an essay about how debt influences their career choices. The authors analyzed 132 essays using immersion and crystallization and iterative, team-based coding. Code-recode strategies, member checking, and reflexivity ensured validity and rigor. Three themes emerged about the meaning of debt: debt symbolizes lack of social investment, debt reinforces a sense of entitlement, and debt is a collective experience. Four approaches to debt management emerged: anticipation, avoidance, acceptance, and disempowerment. Insights: Medical students' views of debt are more complex than previously reported. Medical educators should recognize that many students experience debt as a stressor, acknowledge students' emotions about debt, and invite discussion about the culture of entitlement in medical education and how this culture affects students' professionalism. At the same time, educators should emphasize that students have many repayment options and that regardless

  6. Capability of simultaneous Rayleigh LiDAR and O2 airglow measurements in exploring the short period wave characteristics

    Science.gov (United States)

    Taori, Alok; Raghunath, Karnam; Jayaraman, Achuthan

    We use combination of simultaneous measurements made with Rayleigh lidar and O2 airglow monitoring to improve lidar investigation capability to cover a higher altitude range. We feed instantaneous O2 airglow temperatures instead the model values at the top altitude for subsequent integration method of temperature retrieval using Rayleigh lidar back scattered signals. Using this method, errors in the lidar temperature estimates converges at higher altitudes indicating better altitude coverage compared to regular methods where model temperatures are used instead of real-time measurements. This improvement enables the measurements of short period waves at upper mesospheric altitudes (~90 km). With two case studies, we show that above 60 km the few short period wave amplitude drastically increases while, some of the short period wave show either damping or saturation. We claim that by using such combined measurements, a significant and cost effective progress can be made in the understanding of short period wave processes which are important for the coupling across the different atmospheric regions.

  7. TU-FG-209-03: Exploring the Maximum Count Rate Capabilities of Photon Counting Arrays Based On Polycrystalline Silicon

    Energy Technology Data Exchange (ETDEWEB)

    Liang, A K; Koniczek, M; Antonuk, L E; El-Mohri, Y; Zhao, Q [University of Michigan, Ann Arbor, MI (United States)

    2016-06-15

    Purpose: Photon counting arrays (PCAs) offer several advantages over conventional, fluence-integrating x-ray imagers, such as improved contrast by means of energy windowing. For that reason, we are exploring the feasibility and performance of PCA pixel circuitry based on polycrystalline silicon. This material, unlike the crystalline silicon commonly used in photon counting detectors, lends itself toward the economic manufacture of radiation tolerant, monolithic large area (e.g., ∼43×43 cm2) devices. In this presentation, exploration of maximum count rate, a critical performance parameter for such devices, is reported. Methods: Count rate performance for a variety of pixel circuit designs was explored through detailed circuit simulations over a wide range of parameters (including pixel pitch and operating conditions) with the additional goal of preserving good energy resolution. The count rate simulations assume input events corresponding to a 72 kVp x-ray spectrum with 20 mm Al filtration interacting with a CZT detector at various input flux rates. Output count rates are determined at various photon energy threshold levels, and the percentage of counts lost (e.g., due to deadtime or pile-up) is calculated from the ratio of output to input counts. The energy resolution simulations involve thermal and flicker noise originating from each circuit element in a design. Results: Circuit designs compatible with pixel pitches ranging from 250 to 1000 µm that allow count rates over a megacount per second per pixel appear feasible. Such rates are expected to be suitable for radiographic and fluoroscopic imaging. Results for the analog front-end circuitry of the pixels show that acceptable energy resolution can also be achieved. Conclusion: PCAs created using polycrystalline silicon have the potential to offer monolithic large-area detectors with count rate performance comparable to those of crystalline silicon detectors. Further improvement through detailed circuit

  8. An exploration of the dynamics and influences upon second medical opinion consultations in cancer care.

    Science.gov (United States)

    Philip, Jennifer; Gold, Michelle; Schwarz, Max; Komesaroff, Paul

    2011-03-01

    The aim of this study was to explore the dynamics within second medical opinion consultations in patients with cancer. Semi-structured interviews were held with four oncologists and were subjected to a thematic analysis to define the broad issues. These formed the basis of a survey distributed to Australian medical oncologists. Overall 65 surveys were returned representing an overall response rate of 30% (10% and 63% electronic and hardcopy response rates, respectively). The dynamics in giving second medical opinions are influenced by the collegiate relationships of the doctors. Nearly two-thirds of oncologists believed that the first doctors' treatment and recommendations influenced the outcome of the second opinion, more than one-third believed the outcome was influenced by the relationship between the two doctors, and 41% believed the public nature of a second opinion was influential. In each case, these figures were more than double their assessments of patients' beliefs of these influences. Care was taken not to criticise the primary doctor. Second medical opinions provide an opportunity for oncologists to review medical care and engage in enhanced communication with patients who have additional needs. These consultations do not, however, occur in a vacuum but are influenced by the need to attend to relationships between the patient and their primary doctor and between the doctors themselves. The second medical opinion is embedded within a network of relationships and within the illness journey. © 2010 Blackwell Publishing Asia Pty Ltd.

  9. Adaptive Capabilities of the Eastern Imperial Eagle in Power Lines Exploration for Nesting Purposes in the Republic of Tatarstan, Russia

    Directory of Open Access Journals (Sweden)

    Rinur H. Bekmansurov

    2016-02-01

    Full Text Available This report presents information on the eastern imperial eagle nesting on electricity pylons in the Republic of Tatarstan (area of 67836.2 km2 on the eastern part of East-European (Russian Plain, where the habitat of this species, marked in GIS (ArcView 3.2a, is 49 thousand km2. During the research in 2011–2015 5 nests were found on steel electricity pylons, which sustains 3.25% from the whole amount of nesting areas (n=154. Rather local disposition of all found cases of nests on electricity pylons in Eastern Zakamye (High Zavolzhye limited by one landscape subzone – typical and southern forest-steppe, and in only two landscape regions with adjacent borders – indicates some general conditions which caused the adaptation.  Distance between nests on power lines in the Republic of Tatarstan ranged from 21.5 to 49.9 km, averaging 29.5±13.64 km (n=5. As this territory lacks interspecific competition, the main reason of nesting on electricity pylons is probably the reduction of distance to forage resources in conditions of intraspecific competition in the densest nesting group. Adaptive capabilities of the Eastern Imperial Eagle are connected with their ability to occupy nests of other birds, high tolerance to human influence, and with the high density of the power lines and low density of long-boled forests. It’s reported that the imperial eagles’ adaptation to living in environment with dense power line network continues, which expresses in increase of the nesting on electricity pylons.

  10. Exploration of a capability-focused aerospace system of systems architecture alternative with bilayer design space, based on RST-SOM algorithmic methods.

    Science.gov (United States)

    Li, Zhifei; Qin, Dongliang; Yang, Feng

    2014-01-01

    In defense related programs, the use of capability-based analysis, design, and acquisition has been significant. In order to confront one of the most challenging features of a huge design space in capability based analysis (CBA), a literature review of design space exploration was first examined. Then, in the process of an aerospace system of systems design space exploration, a bilayer mapping method was put forward, based on the existing experimental and operating data. Finally, the feasibility of the foregoing approach was demonstrated with an illustrative example. With the data mining RST (rough sets theory) and SOM (self-organized mapping) techniques, the alternative to the aerospace system of systems architecture was mapping from P-space (performance space) to C-space (configuration space), and then from C-space to D-space (design space), respectively. Ultimately, the performance space was mapped to the design space, which completed the exploration and preliminary reduction of the entire design space. This method provides a computational analysis and implementation scheme for large-scale simulation.

  11. On the utility of 3D hand cursors to explore medical volume datasets with a touchless interface.

    Science.gov (United States)

    Lopes, Daniel Simões; Parreira, Pedro Duarte de Figueiredo; Paulo, Soraia Figueiredo; Nunes, Vitor; Rego, Paulo Amaral; Neves, Manuel Cassiano; Rodrigues, Pedro Silva; Jorge, Joaquim Armando

    2017-08-01

    Analyzing medical volume datasets requires interactive visualization so that users can extract anatomo-physiological information in real-time. Conventional volume rendering systems rely on 2D input devices, such as mice and keyboards, which are known to hamper 3D analysis as users often struggle to obtain the desired orientation that is only achieved after several attempts. In this paper, we address which 3D analysis tools are better performed with 3D hand cursors operating on a touchless interface comparatively to a 2D input devices running on a conventional WIMP interface. The main goals of this paper are to explore the capabilities of (simple) hand gestures to facilitate sterile manipulation of 3D medical data on a touchless interface, without resorting on wearables, and to evaluate the surgical feasibility of the proposed interface next to senior surgeons (N=5) and interns (N=2). To this end, we developed a touchless interface controlled via hand gestures and body postures to rapidly rotate and position medical volume images in three-dimensions, where each hand acts as an interactive 3D cursor. User studies were conducted with laypeople, while informal evaluation sessions were carried with senior surgeons, radiologists and professional biomedical engineers. Results demonstrate its usability as the proposed touchless interface improves spatial awareness and a more fluent interaction with the 3D volume than with traditional 2D input devices, as it requires lesser number of attempts to achieve the desired orientation by avoiding the composition of several cumulative rotations, which is typically necessary in WIMP interfaces. However, tasks requiring precision such as clipping plane visualization and tagging are best performed with mouse-based systems due to noise, incorrect gestures detection and problems in skeleton tracking that need to be addressed before tests in real medical environments might be performed. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records.

    Science.gov (United States)

    Bardach, Shoshana H; Real, Kevin; Bardach, David R

    2017-05-01

    Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners' experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one's notes. Limitations in technology-including limited computer availability, documentation complexity, and sluggish sign-in processes-also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care.

  13. Capabilities for Strategic Adaptation

    DEFF Research Database (Denmark)

    Distel, Andreas Philipp

    This dissertation explores capabilities that enable firms to strategically adapt to environmental changes and preserve competitiveness over time – often referred to as dynamic capabilities. While dynamic capabilities being a popular research domain, too little is known about what these capabiliti...

  14. How we created a peer-designed specialty-specific selective for medical student career exploration.

    Science.gov (United States)

    Keating, Elizabeth M; O'Donnell, Erin P; Starr, Stephanie R

    2013-01-01

    In recent years, medical students have recognized and advocated for opportunities to explore various specialties earlier in their medical education. A brief literature review, however, reveals little consensus on the best approach to introduce students to different fields during their preclinical years. We present one of the first reports of a student-led effort to design and implement a preclinical specialty-specific elective. At Mayo Medical School, for two consecutive years the student president of the Pediatric Interest Group has created a peer-designed weeklong group elective ("selective") experience consisting of workshops, faculty and resident panel discussions, and clinical shadowing experiences based on a student needs assessment. Each year, more than 25% of the first- and second-year medical student body participated. The majority of students who completed the selective agreed that this experience heightened their interests and expanded their knowledge about pediatrics. The pediatric group selective has provided students with important resources for their medical education and future careers. Students found the group selective beneficial to their learning experience and recommend continuing to offer it in the future.

  15. Managing Complexity: Exploring Decision Making on Medication by Young Adults with ADHD.

    Science.gov (United States)

    Druedahl, Louise C; Kälvemark Sporrong, Sofia

    2018-04-19

    Attention-deficit hyperactivity disorder (ADHD) causes difficulties with hyperactivity, impulsivity and inattention. Treatment of ADHD includes both medication and non-pharmacological options. Knowledge of treatment preferences by young adults with ADHD is sparse. The objective of this study was to explore the beliefs and experiences of young adults with ADHD related to their medication treatment decisions. Data were collected in Denmark in 2016 through a focus group and individual in-depth interviews. Conventional content analysis was used. Ten young adults with ADHD (22-to 29-year-old) participated. Three major themes were identified: (1) the patient’s right to choose concerning ADHD medicine; (2) the patient’s decision of whether or not to treat ADHD with medication; and (3) factors affecting the patient’s decision on whether to take ADHD medication or not. The latter theme contained 15 factors, which were distributed across three levels: individual, between-individuals, and societal. The dominant factors were increasing quality of life and improving oneself e.g., improving social skills. For counselling at the pharmacy and by prescribers, it is important to be aware of the different factors that affect young adult patients’ decisions on whether to take ADHD medication or not. This knowledge will aid to understand reasons for non-adherence and to determine appropriate treatment for the individual patient.

  16. Dual peer mentoring program for undergraduate medical students: exploring the perceptions of mentors and mentees.

    Science.gov (United States)

    Abdolalizadeh, Parya; Pourhassan, Saeed; Gandomkar, Roghayeh; Heidari, Farrokh; Sohrabpour, Amir Ali

    2017-01-01

    Background: Despite the advantages of dual peer mentoring, there are a few reports of implementing and evaluating such programs for medical students. This study aimed at exploring the perceptions of mentors and mentees about the dual peer mentoring program for the first year undergraduate medical students of Tehran University of Medical Sciences. Methods: This qualitative study was conducted at the end of the first year of implementing the mentoring program. All mentees and mentors were invited to participate in focus group discussions. Data were analyzed using a qualitative content analysis. Results: All mentors ( n= 12 ) and a group of mentees ( n= 21 ) participated in focus group discussion sessions. We provided a variety of supports for the mentees including academic and psychosocial support and positive relationship; as a result, some developments occurred to the mentors We also explored participants' views on some unique aspects of the program such as student-authorized, dual mentoring, and role model sessions. Conclusion: Our participants found the mentoring program beneficial in various academic achievements and psychosocial supports for both the mentors and the mentees. Dual peer mentoring program can be an alternative to school administered programs.

  17. Exploring the Top-Cited and Most Influential Articles in Medical Education.

    Science.gov (United States)

    Azer, Samy A

    2016-01-01

    The citations received by a scientific publication have been used as a proxy measurement of scientific quality and in ranking researchers. Although these practices have been observed in several institutes, careful assessment of top-cited articles may provide more insight into exploring their characteristics. The aim of this study was to analyze the top-cited articles in medical education identified by Azer 2015 and explore the characteristics of these articles that can provide insight into their assessment. The most frequently cited articles identified by searching the Web of Science under the category "Education, Scientific Discipline" were included in the analysis. The following issues were further analyzed: 1) comparing the mean yearly citations received by articles published before the year 2000 and those published after, 2) assessing whether there was a correlation between the number of grants, number of authors, number of institutes, or number of countries involved and the number of citations received, 3) assessing the number of female representation in authorship, 4) assessing the representation of none-medical staff in the authorship, and 5) exploring any association between top authors identified and those who were awarded the Karolinska Institutet Prize for research in medical education. Although there was no correlation between the number of citations and the number of years since publications, the mean number of citations received by articles published before the year 2000 varied from zero to 18.2 ± 16.6, whereas for those published after the year 2000 the mean varied from 2.0 ± 2.1 to 35.3 ± 26.8. No correlation was found between the number of citations obtained and number of grants, number of authors, number of institutes, or number of countries involved. Females comprised 50% of the total number of authors. However, no correlation was found between the number of females in authorship and the number of citations obtained. Similarly, the number of

  18. Nurses Exploring the Spirituality of Their Patients With Cancer: Participant Observation on a Medical Oncology Ward.

    Science.gov (United States)

    van Meurs, Jacqueline; Smeets, Wim; Vissers, Kris C P; Groot, Marieke; Engels, Yvonne

    2017-07-19

    Attention for spirituality should be an integral part of professionals' caregiving. Particularly, nurses caring for patients with cancer might have opportunities to give attention to this dimension. The aim of this study was to gain insight in the way and extent to which nurses during daily caregiving observe and explore spiritual issues of hospitalized patients with cancer. We performed an ethnographic study with participant observation. Data were collected in 2015 during 4 shifts at the medical oncology department of a university hospital. The researcher, a spiritual care provider (chaplain) wearing the same kind of uniform as the nurses, observed the nurses, participated in their actions, and interviewed them after the shift. Although the patients did send many implicit and explicit messages concerning spiritual issues, the nurses did not explore them. If noticed, 3 barriers for exploring spiritual issues were mentioned by the nurses: lack of time, conflict with their mindset, and being reserved to talk about such issues. During their daily caregiving to patients with a life-threatening illness, nurses have many opportunities to explore spiritual issues, but they do not often recognize them. If they do, they tend not to explore the spiritual issues. Communication training for nurses is necessary to develop skills for exploring the spiritual dimension in patients with cancer. In such training, attention to the misconception that such a conversation requires a lot of time and for recognizing signals from patients inviting an exploration of their concerns is necessary.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  19. Exploring the practical themes for medical education social accountability in Iran.

    Science.gov (United States)

    Ahmady, Soleiman; Akbari Lakeh, Maryam

    2015-01-01

    The purpose of this paper is to explore themes for enhancing socially accountability in medical education. Medical education in Iran experience new challenges due to the enormous influence of changes in technology, development of new methods of teaching and learning, student requirements, patient management, financial credit constraints, and social and economic developments. For responding to these, use of strategic thinking in order to make appropriate decisions is the only solution. Strategic plans need to formulate practical guides which can help accountable to people's reasonable expectations. For this qualitative study, along with the 14(th)national conference on Medical Education in Iran, the opinions of experts were obtained during seven expert panels' group discussions, each lasting four hours and including 10 participants. Data were collected by audiotapes, which were then transcribed. Data analyzed using a thematic content analysis approach. Peer and member checking during analysis and data triangulation from other recent studies were used to increase the findings' trustworthiness. Among more than hundred meaning units groups identified the following eight main themes as affecting the social accountable medical education in Iran: organization of responsive education councils; development of community based courses; development in field training; organization of educational processes; homogeneity in educational rules and regulations; budget management, educational outcomes; educational programs in departments and groups. This study have found the main themes that might affecting social accountable medical education in Iran, where Iranian policymakers should consider those when plan to make changes in medical education and could potentially adopt the proven useful policies and strategies of other countries.

  20. An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean

    Science.gov (United States)

    Youssef, Farid F.; Nunes, Paula; Sa, Bidyadhar; Williams, Stella

    2014-01-01

    Objectives: This study explored the empathy profile of students across five years of medical training. In addition the study examined whether the Jefferson Scale for Physician Empathy correlated with a measure of cognitive empathy, the Reading the Mind in the Eyes Test and a measure of affective empathy, the Toronto Empathy Questionnaire. Methods: The study was a comparative cross-sectional design at one Caribbean medical school. Students were contacted in class, participation was voluntary and empathy was assessed using all three instruments Descriptive statistics were calculated and differences between groups evaluated using non-parametric tests. Results: Overall 669 students participated (response rate, 67%). There was a significant correlation between the Jefferson Scale of Physician Empathy and the Toronto Empathy Questionnaire (P = 0.48), both scales indicating a decline in medical student empathy scores over time. There was, however, little correlation between scores from the Reading the Mind in the Eyes Test and the Jefferson Scale of Physician Empathy. Female students demonstrated significantly higher scores on all three measures. Conclusions: Medical students’ lower empathy scores during their final years of training appear to be due to a change in the affective component of empathy. These findings may reflect an adaptive neurobiological response to the stressors associated with encountering new clinical situations. Attention should be paid not only to providing empathy training for students but also to teaching strategies for improved cognitive processing capacity when they are encountering new and challenging circumstances. PMID:25341229

  1. Five different types of framing effects in medical situation: a preliminary exploration.

    Science.gov (United States)

    Peng, Jiaxi; Li, Hongzheng; Miao, Danmin; Feng, Xi; Xiao, Wei

    2013-02-01

    Considerable reports concerned the framing effect in medical situations. But quite few of them noticed to explore the differences among the various kinds of framing effects. In the present study, five different types of framing effects were examined and the effect sizes of them were compared. Medical decision making problems concerning medicine effect evaluation, patient's compliance, treatment and doctor options selection were established. All the problems were described in both positive and negative frames. 500 undergraduates as participants were randomly divided into ten groups. Participants from each group were asked to finish one decision making task. ALL THE FRAMES THAT WERE EXAMINED LEADED TO SIGNIFICANT FRAMING EFFECTS: When the Asia Disease Problem was described in a positive frame, the participants preferred the conservative frame than the risky one, while if in a negative frame, the preference reversed (P make more positive evaluations, compared with described as "of 100 patients taking this kind of medicine, 30 patients didn't become better" (P frame and the former one resulted in a better compliance (P framing effect was also tested to be significant (P framing effects were small to big in effect size. Medical decision making can be affected by frame descriptions. Attentions should be paid on the standardization of description in medical practice.

  2. Leadership and followership in the healthcare workplace: exploring medical trainees’ experiences through narrative inquiry

    Science.gov (United States)

    Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

    2015-01-01

    Objectives To explore medical trainees’ experiences of leadership and followership in the interprofessional healthcare workplace. Design A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. Setting Multisite study across four UK health boards. Participants Through maximum variation sampling, 65 medical trainees were recruited from a range of specialties and at various stages of training. Participants shared stories about their experiences of leadership and followership in the healthcare workplace. Methods Data were analysed using thematic and narrative analysis. Results We identified 171 personal incident narratives about leadership and followership. Participants most often narrated experiences from the position of follower. Their narratives illustrated many factors that facilitate or inhibit developing leadership identities; that traditional medical and interprofessional hierarchies persist within the healthcare workplace; and that wider healthcare systems can act as barriers to distributed leadership practices. Conclusions This paper provides new understandings of the multiple ways in which leadership and followership is experienced in the healthcare workplace and sets out recommendations for future leadership educational practices and research. PMID:26628525

  3. Exploring stakeholders' views of medical education research priorities: a national survey.

    Science.gov (United States)

    Dennis, Ashley A; Cleland, Jennifer A; Johnston, Peter; Ker, Jean S; Lough, Murray; Rees, Charlotte E

    2014-11-01

    Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These

  4. 3D Printing: Exploring Capabilities

    Science.gov (United States)

    Samuels, Kyle; Flowers, Jim

    2015-01-01

    As 3D printers become more affordable, schools are using them in increasing numbers. They fit well with the emphasis on product design in technology and engineering education, allowing students to create high-fidelity physical models to see and test different iterations in their product designs. They may also help students to "think in three…

  5. Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC: a qualitative study

    Directory of Open Access Journals (Sweden)

    Adams Sherri

    2013-01-01

    Full Text Available Abstract Background The Medical Home model recommends that Children with Special Health Care Needs (CSHCN receive a medical care plan, outlining the child’s major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs of children with medical complexity (CMC. Methods This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15 and parents (n = 15 of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. Results A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Conclusions Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how

  6. Exploring reflective 'critical incident' documentation of professionalism lapses in a medical undergraduate setting

    Directory of Open Access Journals (Sweden)

    McLachlan John C

    2009-07-01

    Full Text Available Abstract Background Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting. Methods We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed. Results This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative, and student responses regarding future actions. Conclusion This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.

  7. Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

    Science.gov (United States)

    Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

    2011-01-01

    The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

  8. Medical technology integration: CT, angiography, imaging-capable OR-table, navigation and robotics in a multifunctional sterile suite.

    Science.gov (United States)

    Jacob, A L; Regazzoni, P; Bilecen, D; Rasmus, M; Huegli, R W; Messmer, P

    2007-01-01

    Technology integration is an enabling technological prerequisite to achieve a major breakthrough in sophisticated intra-operative imaging, navigation and robotics in minimally invasive and/or emergency diagnosis and therapy. Without a high degree of integration and reliability comparable to that achieved in the aircraft industry image guidance in its different facets will not ultimately succeed. As of today technology integration in the field of image-guidance is close to nonexistent. Technology integration requires inter-departmental integration of human and financial resources and of medical processes in a dialectic way. This expanded techno-socio-economic integration has profound consequences for the administration and working conditions in hospitals. At the university hospital of Basel, Switzerland, a multimodality multifunction sterile suite was put into operation after a substantial pre-run. We report the lessons learned during our venture into the world of medical technology integration and describe new possibilities for similar integration projects in the future.

  9. An exploration of contextual dimensions impacting goals of care conversations in postgraduate medical education.

    Science.gov (United States)

    Roze des Ordons, Amanda L; Lockyer, Jocelyn; Hartwick, Michael; Sarti, Aimee; Ajjawi, Rola

    2016-03-21

    Postgraduate medical trainees are not well prepared difficult conversations about goals of care with patients and families in the acute care clinical setting. While contextual nuances within the workplace can impact communication, research to date has largely focused on individual communication skills. Our objective was to explore contextual factors that influence conversations between trainees and patients/families about goals of care in the acute care setting. We conducted an exploratory qualitative study involving five focus groups with Internal Medicine trainees (n = 20) and a series of interviews with clinical faculty (n = 11) within a single Canadian centre. Thematic framework analysis was applied to categorize the data and identify themes and subthemes. Challenges and factors enabling goals of care conversations emerged within individual, interpersonal and system dimensions. Challenges included inadequate preparation for these conversations, disconnection between trainees, faculty and patients, policies around documentation, the structure of postgraduate medical education, and resource limitations; these challenges led to missed opportunities, uncertainty and emotional distress. Enabling factors were awareness of the importance of goals of care conversations, support in these discussions, collaboration with colleagues, and educational initiatives enabling skill development; these factors have resulted in learning, appreciation, and an established foundation for future educational initiatives. Contextual factors impact how postgraduate medical trainees communicate with patients/families about goals of care. Attention to individual, interpersonal and system-related factors will be important in designing educational programs that help trainees develop the capacities needed for challenging conversations.

  10. Social media and medical education: Exploring the potential of Twitter as a learning tool.

    Science.gov (United States)

    Jalali, Alireza; Sherbino, Jonathan; Frank, Jason; Sutherland, Stephanie

    2015-04-01

    This study set out to explore the ways in which social media can facilitate learning in medical education. In particular we were interested in determining whether the use of Twitter during an academic conference can promote learning for participants. The Twitter transcript from the annual International Conference on Residency Education (ICRE) 2013 was qualitatively analysed for evidence of the three overarching cognitive themes: (1) preconceptions, (2) frameworks, and (3) metacognition/refl ection in regard to the National Research Council ’ s (NRC) How People Learn framework . Content analysis of the Twitter transcript revealed evidence of the three cognitive themes as related to how people learn. Twitter appears to be most effective at stimulating individuals ’ preconceptions, thereby engaging them with the new material acquired during a medical education conference. The study of social media data, such as the Twitter data used in this study, is in its infancy. Having established that Twitter does hold signifi cant potential as a learning tool during an academic conference, we are now in a better position to more closely examine the spread, depth, and sustainability of such learning during medical education meetings.

  11. Exploring the implications of the influence of organisational culture on work-life balance practices: evidence from Nigerian medical doctors

    OpenAIRE

    Adisa, Toyin Ajibade; Modi, Chima; Osabutey, Ellis L. C.

    2017-01-01

    Purpose - Whilst significant evidence of western work-life balance (WLB) challenges exists, studies that explore Sub-Saharan Africa (SSA) are scarce. This article explores how organisational culture in Nigerian medical organisations influences doctors’ WLB and examines the implications of supportive and unsupportive cultures on doctors’ WLB. \\ud \\ud Methodology - The paper uses qualitative data gleaned from semi-structured interviews of 60 medical doctors across the six geo-political zones of...

  12. Capability Paternalism

    NARCIS (Netherlands)

    Claassen, R.J.G.|info:eu-repo/dai/nl/269266224

    A capability approach prescribes paternalist government actions to the extent that it requires the promotion of specific functionings, instead of the corresponding capabilities. Capability theorists have argued that their theories do not have much of these paternalist implications, since promoting

  13. General practitioners' perceptions of the effectiveness of medical interventions: an exploration of underlying constructs

    Directory of Open Access Journals (Sweden)

    Marteau Theresa M

    2010-02-01

    Full Text Available Abstract Background Many interventions shown to be effective through clinical trials are not readily implemented in clinical practice. Unfortunately, little is known regarding how clinicians construct their perceptions of the effectiveness of medical interventions. This study aims to explore general practitioners' perceptions of the nature of 'effectiveness'. Methods The design was qualitative in nature using the repertory grid technique to elicit the constructs underlying the perceived effectiveness of a range of medical interventions. Eight medical interventions were used as stimuli (diclophenac to reduce acute pain, cognitive behaviour therapy to treat depression, weight loss surgery to achieve weight loss, diet and exercise to prevent type 2 diabetes, statins to prevent heart disease, stopping smoking to prevent heart disease, nicotine replacement therapy to stop smoking, and stop smoking groups to stop smoking. The setting involved face-to-face interviews followed by questionnaires in London Primary Care Trusts. Participants included a random sample of 13 general practitioners. Results Analysis of the ratings showed that the constructs clustered around two dimensions: low patient effort versus high patient effort (dimension one, and small impact versus large impact (dimension two. Dimension one represented constructs such as 'success requires little motivation', 'not a lifestyle intervention', and 'health-care professional led intervention'. Dimension two represented constructs such as 'weak and/or minimal evidence of effectiveness', 'small treatment effect for users', 'a small proportion of users will benefit' and 'not cost-effective'. Constructs within each dimension were closely related. Conclusions General practitioners judged the effectiveness of medical interventions by considering two broad dimensions: the extent to which interventions involve patient effort, and the size of their impact. The latter is informed by trial evidence, but

  14. Compact Neutron Generators for Medical, Home Land Security, and Planetary Exploration

    CERN Document Server

    Reijonen, Jani

    2005-01-01

    The Plasma and Ion Source Technology Group at Lawrence Berkeley National Laboratory has developed various types of advanced D-D (neutron energy 2.5 MeV), D-T (14 MeV) and T-T (0 - 9 MeV) neutron generators for wide range of applications. These applications include medical (Boron Neutron Capture Therapy), homeland security (Prompt Gamma Activation Analysis, Fast Neutron Activation Analysis and Pulsed Fast Neutron Transmission Spectroscopy) and planetary exploration in form of neutron based, sub-surface hydrogen detection systems. These neutron generators utilize RF induction discharge to ionize the deuterium/tritium gas. This discharge method provides high plasma density for high output current, high atomic species from molecular gases, long life operation and versatility for various discharge chamber geometries. Three main neutron generator developments are discussed here: high neutron output co-axial neutron generator for BNCT applications, point neutron generator for security applications, compact and sub-c...

  15. Exploring talent development environments –inspirations to medical education at doctoral level

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; Lund, Ole; Mørcke, Anne Mette

    Introduction: Doctoral students may be considered some of our most talented students. In order to maintain high quality in doctoral education we should be aware of optimizing the talent development environment in which the students develop their competencies. In this paper we explore the features...... has been on cognitive skills of individual talents and to a minor degree on institutional conditions and constraints within talent development environments. However, recent studies on talent development in sport recognize ‘talent’ as a social construction (1) and institutional and environmental...... features playing a decisive role in talent development (2). Our research question is: do concepts and models for talent development environments in sport apply to medical education at doctoral level? Considering the uniqueness of the two domains (they refer to different overall social fields: education...

  16. Exploring the transition of undergraduate medical students into a clinical clerkship using organizational socialization theory.

    Science.gov (United States)

    Atherley, Anique E; Hambleton, Ian R; Unwin, Nigel; George, Colette; Lashley, Paula M; Taylor, Charles G

    2016-04-01

    Transitions in medical education are emotionally and socially dynamic; this may affect learning. Students transitioning from preclinical to clinical training may experience negative consequences. Less is understood about students' experiences during transitions within clinical training and influential factors. The authors used organizational socialization theory to explore a transition within the clinical years. Final-year medical students experienced a nine-week internal medicine clerkship; willing students participated. Students (n = 101; 97 %) completed a questionnaire with open-ended questions at the beginning and end of the clerkship and participated in six consecutive focus groups, until data saturation occurred (n = 37). Data were thematically analyzed. Socialization was challenging. Many students experienced difficulty developing relationships with team members. Students with a positive attitude experienced a smoother transition. Many students were uncertain of their roles, concerned about the workload and desired guidance to meet clerkship demands. This transition resulted in varied outcomes from enjoyment, increased confidence and student development through to disinterest. Transitions within clinical training are complex. Faculty should focus on adequate socialization in a new clerkship as this may facilitate a smoother transition. This may necessitate orientations, staff training, and formal student support. Further research is needed on the impact of these recommendations on learning and well-being.

  17. Exploring the consequences of combining medical students with and without a background in biomedical sciences.

    Science.gov (United States)

    Ellaway, Rachel H; Bates, Amanda; Girard, Suzanne; Buitenhuis, Deanna; Lee, Kyle; Warton, Aidan; Russell, Steve; Caines, Jill; Traficante, Eric; Graves, Lisa

    2014-07-01

    Medical schools have tended to admit students with strong backgrounds in the biomedical sciences. Previous studies have shown that those with backgrounds in the social sciences can be as successful in medical school as those with science backgrounds. However, the experience of being a 'non-science' student over time has not been well described. A mixed-methods study was developed and run with the aim of elucidating the personal experiences of science and non-science students at our institution. Data were generated from a student survey that focused on participants' self-identification as science or non-science students, and on their sense of preparedness and stress, and from a series of student focus groups exploring participants' experiences of science and non-science issues in all aspects of their training. Descriptive statistics were generated for structured survey data. Focus group data and unstructured survey data were analysed to identify common themes. End-of-module and end-of-year examination data for the four class cohorts in the programme were also analysed to compare science and non-science student performance over time. There were clear differences between the experiences and performance of science and non-science students. We found dichotomies in students' self-reported sense of preparedness and stress levels, and marked differences in their examination performance, which diminished over time to converge around the third year of their studies. Combining science and non-science students in the same class affected the students to different extents and in different ways. The potential disruption of mixing science and non-science students diminished as their levels of performance converged. The psychosocial stress experienced by non-science students and the challenges it posed, in both their academic and their personal lives, have implications for how such students should be supported, and how curricula can be configured to afford quality learning for all

  18. Integrated Medical Model – Chest Injury Model

    Data.gov (United States)

    National Aeronautics and Space Administration — The Exploration Medical Capability (ExMC) Element of NASA's Human Research Program (HRP) developed the Integrated Medical Model (IMM) to forecast the resources...

  19. Re-exploration after open heart surgery at the madras medical mission, chennai, India.

    Science.gov (United States)

    Okonta, Ke; Rajan, S

    2011-04-01

    Re-explorations after open-heart surgery is a necessity in this Cardiac Center when a patient is obviously bleeding or shows features of cardiovascular instability. Timely intervention may reduce morbidity and mortality. This study aims to correlate the indications with the operative findings for re-explorations after open-heart surgeries as a way of justifying early surgical intervention. Between May2005 and April2011, 10,083 open-heart surgeries were performed in the Adult Cardiac Surgical Unit of the department of cardiac surgery, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, India. The demographic data, the initial diagnoses, the types of surgery, the indications for re-exploration, the intraoperative findings, the timing, the estimated blood loss and treatment for the 362 patients who had reexploration were analysed using the Predictive Analysis Soft -ware(PASW)18. Out of the 10,083 patients who had cardiac operation within the period of study, three hundred and sixty two (3.6%) patients had re-exploration shortly after the operation. Males were 311(85.9%) while 51(14.1%) were female patients with mean age of 56.7+12.5years .The mean time interval between the primary surgery and the re-exploratory operation was 2.31+1.47hours and the mean chest tube drainage before re-exploration was 770.9+28.8ml. Coronary Artery Diseases (CAD) was the initial diagnosis 258 (71.3%) patients and Coronary Artery Bypass(CABG) operation was the initial surgery in 254(70.2%)patients, CABG and valve in 12(3.3%)patients, Valve surgery alone in 70(19.3%) patients, Bentall procedure(homograft aortic root replacement)in 13(3.6%) patients, others such as off-pump coronary artery bypass, Dor procedure(patch restoration of left ventricle by incising the aneurysm without excising it), pericardiectomy and thromboembelectomy in 13(3.6%). The indications for re-exploration were post operative haemorrhage in 283(78.2%) patients, Cardiac tamponade in 41(11.3%)patients

  20. Visual analytics in healthcare education: exploring novel ways to analyze and represent big data in undergraduate medical education.

    Science.gov (United States)

    Vaitsis, Christos; Nilsson, Gunnar; Zary, Nabil

    2014-01-01

    Introduction. The big data present in the medical curriculum that informs undergraduate medical education is beyond human abilities to perceive and analyze. The medical curriculum is the main tool used by teachers and directors to plan, design, and deliver teaching and assessment activities and student evaluations in medical education in a continuous effort to improve it. Big data remains largely unexploited for medical education improvement purposes. The emerging research field of visual analytics has the advantage of combining data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognize visual patterns. Nevertheless, there is a lack of research on the use and benefits of visual analytics in medical education. Methods. The present study is based on analyzing the data in the medical curriculum of an undergraduate medical program as it concerns teaching activities, assessment methods and learning outcomes in order to explore visual analytics as a tool for finding ways of representing big data from undergraduate medical education for improvement purposes. Cytoscape software was employed to build networks of the identified aspects and visualize them. Results. After the analysis of the curriculum data, eleven aspects were identified. Further analysis and visualization of the identified aspects with Cytoscape resulted in building an abstract model of the examined data that presented three different approaches; (i) learning outcomes and teaching methods, (ii) examination and learning outcomes, and (iii) teaching methods, learning outcomes, examination results, and gap analysis. Discussion. This study identified aspects of medical curriculum that play an important role in how medical education is conducted. The implementation of visual analytics revealed three novel ways of representing big data in the undergraduate medical education context. It appears to be a useful tool to explore such data

  1. Visual analytics in healthcare education: exploring novel ways to analyze and represent big data in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Christos Vaitsis

    2014-11-01

    Full Text Available Introduction. The big data present in the medical curriculum that informs undergraduate medical education is beyond human abilities to perceive and analyze. The medical curriculum is the main tool used by teachers and directors to plan, design, and deliver teaching and assessment activities and student evaluations in medical education in a continuous effort to improve it. Big data remains largely unexploited for medical education improvement purposes. The emerging research field of visual analytics has the advantage of combining data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognize visual patterns. Nevertheless, there is a lack of research on the use and benefits of visual analytics in medical education.Methods. The present study is based on analyzing the data in the medical curriculum of an undergraduate medical program as it concerns teaching activities, assessment methods and learning outcomes in order to explore visual analytics as a tool for finding ways of representing big data from undergraduate medical education for improvement purposes. Cytoscape software was employed to build networks of the identified aspects and visualize them.Results. After the analysis of the curriculum data, eleven aspects were identified. Further analysis and visualization of the identified aspects with Cytoscape resulted in building an abstract model of the examined data that presented three different approaches; (i learning outcomes and teaching methods, (ii examination and learning outcomes, and (iii teaching methods, learning outcomes, examination results, and gap analysis.Discussion. This study identified aspects of medical curriculum that play an important role in how medical education is conducted. The implementation of visual analytics revealed three novel ways of representing big data in the undergraduate medical education context. It appears to be a useful tool to

  2. Exploration Laboratory Analysis

    Science.gov (United States)

    Krihak, M.; Ronzano, K.; Shaw, T.

    2016-01-01

    The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability for manned exploration missions. Since a single, compact space-ready laboratory analysis capability to perform all exploration clinical measurements is not commercially available, the ELA project objective is to demonstrate the feasibility of emerging operational and analytical capability as a biomedical diagnostics precursor to long duration manned exploration missions. The initial step towards ground and flight demonstrations in fiscal year (FY) 2015 was the down selection of platform technologies for demonstrations in the space environment. The technologies selected included two Small Business Innovation Research (SBIR) performers: DNA Medicine Institutes rHEALTH X and Intelligent Optical Systems later flow assays combined with Holomics smartphone analyzer. The selection of these technologies were based on their compact size, breadth of analytical capability and favorable ability to process fluids in a space environment, among several factors. These two technologies will be advanced to meet ground and flight demonstration success criteria and requirements that will be finalized in FY16. Also, the down selected performers will continue the technology development phase towards meeting prototype deliverables in either late 2016 or 2017.

  3. Exploration

    International Nuclear Information System (INIS)

    Lohrenz, J.

    1992-01-01

    Oil and gas exploration is a unique kind of business. Businesses providing a vast and ever-changing panoply of products to markets are a focus of several disciplines' energetic study and analysis. The product inventory problem is robust, pertinent, and meaningful, and it merits the voluminous and protracted attention received from keen business practitioners. Prototypical business practitioners, be they trained by years of business hurly-burly, or sophisticated MBAs with arrays of mathematical algorithms and computers, are not normally prepared, however, to recognize the unique nature of exploration's inventories. Put together such a business practitioner with an explorationist and misunderstandings, hidden and open, are inevitable and predictably rife. The first purpose of this paper is to articulate the inherited inventory handling paradigms of business practitioners in relation to exploration's inventories. To do so, standard pedagogy in business administration is used and a case study of an exploration venture is presented. A second purpose is to show the burdens that the misunderstandings create. The result is not just business plans that go awry, but public policies that have effects opposite from those intended

  4. Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates.

    Science.gov (United States)

    Verma, Anju; Griffin, Ann; Dacre, Jane; Elder, Andrew

    2016-06-10

    International Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This "differential attainment" is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients' concerns in a high stakes postgraduate clinical skills examination. Hofstede's cultural dimensions framework was used to look at the impact of culture on examination performance. This was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede's cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure. Five key themes accounted for the majority of communication failures in station 2, "history taking" and station 4, "communication skills and ethics" of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients' concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning. Hofstede's cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede's cultural dimensions theory

  5. A survey exploring the knowledge and perceptions of senior medical students in Nepal toward generic medicines

    Directory of Open Access Journals (Sweden)

    Sudesh Gyawali

    2016-08-01

    Full Text Available Background: The accurate knowledge of generic medicine issues among future prescribers will enhance the prescribing of cost-effective medicines. This study aimed to explore the knowledge and perception of senior medical students about the generic medicines. Methodology: A cross-sectional study was conducted among 237 senior medical students (final year students and interns using a validated self-administered questionnaire. The collected data were analyzed using Statistical Package for the Social Sciences version 20 for windows and comparison of difference was done using linear by linear association. A p value of less than 0.05 was taken as statistically significant. Results: The average age (standard deviation of the respondents was 23.54 (1.39 years. Almost 5% of respondents correctly answered the question regarding the regulatory limits for bioequivalence. Almost two-thirds of respondents correctly agreed that generic medicine is bioequivalent to a brand-name medicine, and 79.3% and 72.5% of respondents correctly agreed that the medicine should be present in the same dosage form and same dose, respectively, as the brand-name medicines. However, almost half of the respondents had impression that brand-name medicines are required to meet higher safety standard than generic medicines. Almost 90% of respondents felt that advertisement by the drug companies would influence the use of brand-name medicine and they need more information about generic medicine. Conclusion: This study highlights the negative perception and knowledge deficit among the respondents. The students’ responses to almost all the statements were almost similar to the respondents’ academic year (final year students and interns, gender and nationality.

  6. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  7. Exploring the attitudes of medical faculty members and students in Pakistan towards plagiarism: a cross sectional survey

    Science.gov (United States)

    Rathore, Farooq Azam; Zia, Ahmad Marjan; Mavrinac, Martina; Farooq, Fareeha

    2015-01-01

    Objective. The objective of this survey was to explore the attitudes towards plagiarism of faculty members and medical students in Pakistan. Methods. The Attitudes Toward Plagiarism questionnaire (ATP) was modified and distributed among 550 medical students and 130 faculty members in 7 medical colleges of Lahore and Rawalpindi. Data was entered in the SPSS v.20 and descriptive statistics were analyzed. The questionnaire was validated by principal axis factoring analysis. Results. Response rate was 93% and 73%, respectively. Principal axis factoring analysis confirmed one factor structure of ATP in the present sample. It had an acceptable Cronbach’s alpha value of 0.73. There were 421 medical students (218 (52%) female, 46% 3rd year MBBS students, mean age of 20.93 ± 1.4 years) and 95 faculty members (54.7% female, mean age 34.5 ± 8.9 years). One fifth of the students (19.7%) trained in medical writing (19.7%), research ethics (25.2%) or were currently involved in medical writing (17.6%). Most of the faculty members were demonstrators (66) or assistant professors (20) with work experience between 1 and 10 years. Most of them had trained in medical writing (68), research ethics (64) and were currently involved in medical writing (64). Medical students and faculty members had a mean score of 43.21 (7.1) and 48.4 (5.9) respectively on ATP. Most of the respondents did not consider that they worked in a plagiarism free environment and reported that self-plagiarism should not be punishable in the same way as plagiarism. Opinion regarding leniency in punishment of younger researchers who were just learning medical writing was divided. Conclusions. The general attitudes of Pakistani medical faculty members and medical students as assessed by ATP were positive. We propose training in medical writing and research ethics as part of the under and post graduate medical curriculum. PMID:26157615

  8. May I see your ID, please? An explorative study of the professional identity of undergraduate medical education leaders.

    Science.gov (United States)

    Sundberg, Kristina; Josephson, Anna; Reeves, Scott; Nordquist, Jonas

    2017-02-01

    The mission of undergraduate medical education leaders is to strive towards the enhancement of quality of medical education and health care. The aim of this qualitative study is, with the help of critical perspectives, to contribute to the research area of undergraduate medical education leaders and their identity formation; how can the identity of undergraduate medical education leaders be defined and further explored from a power perspective? In this explorative study, 14 educational leaders at a medical programme in Scandinavia were interviewed through semi-structured interviews. The data was analysed through Moustakas' structured, phenomenological analysis approach and then pattern matched with Gee's power-based identity model. Educational leaders identify themselves more as mediators than leaders and do not feel to any larger extent that their professional identity is authorised by the university. These factors potentially create difficulties when trying to communicate with medical teachers, often also with a weaker sense of professional identity, about medical education. The perceptions of the professional identity of undergraduate medical education leaders provide us with important notions on the complexities on executing their important mission to develop medical education: their perceptions of ambiguity towards the process of trying to lead teachers toward educational development and a perceived lack of authorisation of their work from the university level. These are important flaws to observe and correct when improving the context in which undergraduate medical education leaders are trying to develop and improve undergraduate medical programmes. A practical outcome of the results of this study is the facilitation of design of faculty development programmes for educational leaders in undergraduate medial education.

  9. Exploring multiple sources of climatic information within personal and medical diaries, Bombay 1799-1828

    Science.gov (United States)

    Adamson, George

    2016-04-01

    Private diaries are being recognised as an important source of information on past climatic conditions, providing place-specific, often daily records of meteorological information. As many were not intended for publication, or indeed to be read by anyone other than the author, issues of observer bias are lower than some other types of documentary sources. This paper comprises an exploration of the variety of types of climatic information can be mined from a single document or set of documents. The focus of the analysis is three private and one medical diary kept by British colonists in Bombay, western India, during the first decades of the nineteenth century. The paper discusses the potential of the diaries for reconstruction of precipitation, temperature and extreme events. Ad-hoc temperature observations collected by the four observers prove to be particularly fruitful for reconstructing monthly extreme temperatures, with values comparable to more systematic observations collected during the period. This leads to a tentative conclusion that extreme temperatures in Bombay were around 5°C lower during the period than today, a difference likely predominantly attributable to the urban heat island effect.

  10. Qualitative descriptive study exploring schizophrenia and the everyday effect of medication-induced weight gain.

    Science.gov (United States)

    Vandyk, Amanda Digel; Baker, Cynthia

    2012-08-01

    Weight gain and obesity are serious side effects of the medications used to manage psychotic disorders and successful, long-term weight loss interventions are not yet available. One reason for this may be that current interventions are designed without consideration of the patient's perspective. The purpose of this study was to explore the subjective experience of weight and lifestyle from the perspective of people with schizophrenia. A qualitative, constructivist research design was used and conversational interviews were conducted with 18 purposefully recruited participants from an outpatient clinic at a psychiatric hospital in Eastern Ontario. Data were analysed according to the method of constant comparison and three central themes emerged: a life altering diagnosis, weight management as complex, and today's experiences shape tomorrow's outcomes. Weight management was seen as difficult yet important to the participants. The findings of this study provide insight into the views and opinions of the participants regarding weight and lifestyle and may be used to support the design of tailored heath initiatives for persons with mental illness. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

  11. A qualitative study to explore communication skills in veterinary medical education.

    Science.gov (United States)

    Hamood, Wendy J; Chur-Hansen, Anna; McArthur, Michelle L

    2014-10-11

    To explore and gain an understanding of what "clinical communication skills" mean to veterinarians working in private practice and what implications this might have for veterinary medical education. Qualitative research methods were used to purposefully sample a range of veterinary practitioners from a pool of South Australian veterinary practices who were interviewed to determine their understanding of what communication skills mean in the context of veterinary practice. Interviews were conducted with fourteen veterinary practitioners. Participants were sampled from a range of ages, veterinary schools of graduation plus urban and rural locations. Interview transcripts were analysed for themes, definitions and contexts. Participants' accounts included a number of skills which they considered to be "communication". Some of the definitions of these skills parallel communication skills and competencies for human medicine on which communication skills training incorporated into veterinary curricula to date have largely been based. However, the veterinarians in this study also raised interesting contextual differences unique to the veterinary profession, such as communication with the animal, selling service, discussing money in relation to decisions for care, and communicating about euthanasia. Veterinary practitioners require high level communication skills. Education and training in veterinary medicine may be better tailored to reflect the unique context of the veterinary profession.

  12. Content and discontent: a qualitative exploration of obstacles to elearning engagement in medical students.

    Science.gov (United States)

    Reid, Helen J; Thomson, Clare; McGlade, Kieran J

    2016-07-22

    Elearning is ubiquitous in healthcare professions education. Its equivalence to 'traditional' educational delivery methods is well established. There is a research imperative to clarify when and how to use elearning most effectively to mitigate the potential of it becoming merely a 'disruptive technology.' Research has begun to broadly identify challenges encountered by elearning users. In this study, we explore in depth the perceived obstacles to elearning engagement amongst medical students. Sensitising concepts of achievement emotions and the cognitive demands of multi-tasking highlight why students' deeply emotional responses to elearning may be so important in their learning. This study used focus groups as a data collection tool. A purposeful sample of 31 participated. Iterative data gathering and analysis phases employed a constant comparative approach to generate themes firmly grounded in participant experience. Key themes that emerged from the data included a sense of injustice, passivity and a feeling of being 'lost at sea'. The actual content of the elearning resource provided important context. The identified themes have strong emotional foundations. These responses, interpreted through the lens of achievement emotions, have not previously been described. Appreciation of their importance is of benefit to educators involved in curriculum development or delivery.

  13. Compact Neutron Generators for Medical Home Land Security and Planetary Exploration

    International Nuclear Information System (INIS)

    Reijonen, J.

    2005-01-01

    The Plasma and Ion Source Technology Group at Lawrence Berkeley National Laboratory has developed various types of advanced D-D (neutron energy 2.5 MeV), D-T (14 MeV) and T-T (0-9 MeV) neutron generators for wide range of applications. These applications include medical (Boron Neutron Capture Therapy), homeland security (Prompt Gamma Activation Analysis, Fast Neutron Activation Analysis and Pulsed Fast Neutron Transmission Spectroscopy) and planetary exploration with a sub-surface material characterization on Mars. These neutron generators utilize RF induction discharge to ionize the deuterium/tritium gas. This discharge method provides high plasma density for high output current, high atomic species from molecular gases, long life operation and versatility for various discharge chamber geometries. Four main neutron generator developments are discussed here: high neutron output co-axial neutron generator for BNCT applications, point neutron generator for security applications, compact and sub-compact axial neutron generator for elemental analysis applications. Current status of the neutron generator development with experimental data will be presented

  14. Characteristics of the Capable Teacher from the Viewpoint of the Students at Faculty of Health, Guilan University of Medical Sciences in 2013

    Directory of Open Access Journals (Sweden)

    Fardin Mehrabian

    2014-09-01

    Full Text Available Teachers are responsible for teaching the students, and improving the teaching quality plays an essential role in the efficiency of the student and teacher. The present study was a descriptive cross-sectional study with a total research sample of 220 people that investigated the characteristics of the capable teacher from the viewpoint of the students at faculty of health, Guilan University of Medical Sciences using census method. Data collection tool was a 24-item questionnaire. The validity of the questionnaire was determined through content validity and its reliability was calculated by Cronbach’s alpha (r=0.87. The collected data were analyzed by SPSS software using descriptive statistics. The most important characteristics of capable teachers from the viewpoint of the students included being knowledgable (90.5%, interest in teaching (78.9%, eloquent presentation (77.3%, accepting criticism (75.5% and flexibility (71.4%, respectively. It is necessary to take these characteristics into consideration while recruiting the faculty members and planning for faculty developement programms.

  15. Capability ethics

    OpenAIRE

    Robeyns, Ingrid

    2012-01-01

    textabstractThe capability approach is one of the most recent additions to the landscape of normative theories in ethics and political philosophy. Yet in its present stage of development, the capability approach is not a full-blown normative theory, in contrast to utilitarianism, deontological theories, virtue ethics, or pragmatism. As I will argue in this chapter, at present the core of the capability approach is an account of value, which together with some other (more minor) normative comm...

  16. Exploring Perception and Use of Everyday Language and Medical Terminology among International Medical Graduates in a Medical ESP Course in Australia

    Science.gov (United States)

    Dahm, Maria R.

    2011-01-01

    Language and communication skills are among the greatest challenges that non-native-English speaking international medical graduates (IMGs) face in English medical consultations. Especially when patients use unfamiliar everyday expressions or attach different meanings to medical terminology, the communicative burden on doctor-patient communication…

  17. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.

    Science.gov (United States)

    Aschbrenner, Kelly A; Pepin, Renee; Mueser, Kim T; Naslund, John A; Rolin, Stephanie A; Faber, Marjan J; Bartels, Stephen J

    2014-01-01

    Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received little attention. This study explored family involvement in medical care for older adults with SMI. This mixed methods study involved analysis of quantitative data collected from older adults with SMI and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives (n = 13) to explore family involvement in medical care. Approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care. Family members identified obesity as their relative's primary health concern and many wanted guidance from providers on effective strategies for supporting weight loss. Although many family members did not perceive a need to be involved in their relative's routine medical visits, they expressed interest in talking with providers about how to help their relative change unhealthy behaviors. Educating patients, families, and providers about the potential benefits of family involvement in medical care, including routine medical visits for persons with SMI and cardiovascular health risk may promote patient- and family-centered collaboration in this high-risk population.

  18. Emergency Medical Response Capability Analysis

    Science.gov (United States)

    1982-07-01

    Analgesics, non-narcotic Anesthesia aooaratus Antibiotics and anti-bacterials Basin, qash, solution Antidiabetic Agents (Oral) Blade, surgical Knife...for replace- Holder, suture needle nent therapy Inhaler, anesthesia , Yankauer (atner fask) Local anesthetics Intravenous injection sets Lubricant...Medium-Spectrum Erythromycin Kanamycin Clindamycin Narrow-Spectrum Penicillins Oxacillin Methicillin Streptomycin Gentamicin Other Amphotericin B Nystatin

  19. Contribution of Sudanese medical diaspora to the healthcare delivery system in Sudan: exploring options and barriers.

    Science.gov (United States)

    Abdalla, Fayrouz Mohammed; Omar, Maye Abu; Badr, Elsheikh Elsiddig

    2016-06-30

    Medical diaspora options, including the engagement of expatriate physicians in development efforts within their home country, are being called for to reverse the effects of brain drain from developing countries. This paper presents the results of a study exploring the potential contributions for the Sudanese Medial Diaspora Options to the healthcare delivery system (HCDS) in Sudan, focusing on the options of temporal and permanent returns and the likely obstacles faced in their implementation. This was a cross-sectional study using a mixed methods design including quantitative and qualitative approaches. For the quantitative approach, the study, which focused on the possible contribution of the diaspora to healthcare delivery in Sudan, was based on an online survey using random purposive and snowballing sampling techniques involving 153 Sudanese physicians working in Saudi Arabia and other Gulf States, the United Kingdom, the Republic of Ireland, and the United States of America. The qualitative approach involved in-depth interviews with returnee physicians and key informants in Sudan, focusing on the return experiences, the barriers for return, and the options to improve future contributions. Despite contributions of the Sudanese medical diaspora being of a small scale considering the size of the phenomenon, as well as infrequent and not appropriately organized, their inputs to academia and the links built with overseas institutions and specialist clinical services were nevertheless remarkable. The main barrier to temporal return was inappropriate organization by the local counterparts, while those for permanent return of physicians were poor work environment, insufficient financial payment, unsecured accommodation, and offspring education. The study identified short-term return as a feasible option considering the country's current conditions. Proper coordination mechanisms for short-term returns and facilitation of permanent return through stakeholders

  20. Empathy in Medical Students: Exploring the Impact of a Longitudinal Integrated Clerkship Model

    Science.gov (United States)

    Bergstresser, Kara

    2017-01-01

    Empathy is considered a significant factor in the physician-patient relationship. The current study examined the impact of a Longitudinal Integrated Clerkship (LIC) model on empathy and patient-centered attitude in medical students. Archival data were examined from 186 medical students at a medical college in the mid-Atlantic region of the United…

  1. Dynamic Capabilities

    DEFF Research Database (Denmark)

    Grünbaum, Niels Nolsøe; Stenger, Marianne

    2013-01-01

    The findings reveal a positive relationship between dynamic capabilities and innovation performance in the case enterprises, as we would expect. It was, however, not possible to establish a positive relationship between innovation performance and profitability. Nor was there any positive...... relationship between dynamic capabilities and profitability....

  2. Capability ethics

    NARCIS (Netherlands)

    I.A.M. Robeyns (Ingrid)

    2012-01-01

    textabstractThe capability approach is one of the most recent additions to the landscape of normative theories in ethics and political philosophy. Yet in its present stage of development, the capability approach is not a full-blown normative theory, in contrast to utilitarianism, deontological

  3. Essential Medical Capabilities and Medical Readiness

    Science.gov (United States)

    2016-07-01

    Bederman, S. S. et al. “The who, what and when of surgery for the degenerative lumbar spine: a population-based study of surgeon factors, surgical...injury, contusion 126 67 18 28 239 Spondylosis , intervertebral disc disorders, other back problems 50 92 35 20 197 Other fractures 75 30 0 55 160...190 5,068 Spondylosis , intervertebral disc disorders, other back problems 151 3,603 703 240 4,697 Sprains and strains 165 3,705 399 417 4,686

  4. Application of Transaction Cost Economics to Capabilities-Based Acquisition: Exploring Single Service vs. Joint Service Programs and Single Systems vs. System-of-Systems

    National Research Council Canada - National Science Library

    Angelis, Diana; Dillard, John; Franck, Raymond; Melese, Francois; Brown, Mary M; Flowe, Robert M

    2008-01-01

    The US Department of Defense (DoD) is in the process of radical transformation -- transformation to a national security strategy predicated on joint Service purchases and complex System-of-Systems (SoS) capabilities...

  5. Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

    OpenAIRE

    Wong, Chin Hoong; Chen, Lee Ping; Koh, Kwee Choy; Chua, Siew Houy; Jong, Darren Chee Hiung; Mohd Fauzi, Nurliyana Mardhiah; Lim, Sue Yin

    2017-01-01

    Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this co...

  6. Gossiping Capabilities

    DEFF Research Database (Denmark)

    Mogensen, Martin; Frey, Davide; Guerraoui, Rachid

    Gossip-based protocols are now acknowledged as a sound basis to implement collaborative high-bandwidth content dissemination: content location is disseminated through gossip, the actual contents being subsequently pulled. In this paper, we present HEAP, HEterogeneity Aware gossip Protocol, where...... nodes dynamically adjust their contribution to gossip dissemination according to their capabilities. Using a continuous, itself gossip-based, approximation of relative capabilities, HEAP dynamically leverages the most capable nodes by (a) increasing their fanouts (while decreasing by the same proportion...... declare a high capability in order to augment their perceived quality without contributing accordingly. We evaluate HEAP in the context of a video streaming application on a 236 PlanetLab nodes testbed. Our results shows that HEAP improves the quality of the streaming by 25% over a standard gossip...

  7. Perceived stress at transition to workplace: a qualitative interview study exploring final-year medical students’ needs

    Directory of Open Access Journals (Sweden)

    Moczko TR

    2016-01-01

    Full Text Available Tobias R Moczko,1,2,* Till J Bugaj,1,* Wolfgang Herzog,1 Christoph Nikendei1 1Department for General Internal and Psychosomatic Medicine, University Hospital of Heidelberg, Heidelberg, 2School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany *These authors contributed equally to this work Objectives: This study was designed to explore final-year medical students’ stressors and coping strategies at the transition to the clinical workplace. Methods: In this qualitative study, semi-standardized interviews with eight final-year medical students (five male, three female; aged 25.9±1.4 years were conducted during their internal medicine rotation. After verbatim transcription, a qualitative content analysis of students’ impressions of stress provoking and easing factors during final-year education was performed. Results: Students’ statements regarding burdens and dealing with stress were classified into four main categories: A perceived stressors and provoking factors, B stress-induced consequences, C personal and external resources for preventing and dealing with stress, and D final-year students’ suggestions for workplace improvement. Conclusion: Final-year medical students perceived different types of stress during their transition to medical wards, and reported both negative consequences and coping resources concerning perceived stress. As supervision, feedback, and coping strategies played an important role in the students’ perception of stress, final-year medical education curricula development should focus on these specifically. Keywords: undergraduate medical education, stress prevention, final-year medical education, workplace learning, qualitative research

  8. An Exploration of Healthcare Inventory and Lean Management in Minimizing Medical Supply Waste in Healthcare Organizations

    Science.gov (United States)

    Hicks, Rodney

    2013-01-01

    The purpose of this study was to understand how lean thinking and inventory management technology minimize expired medical supply waste in healthcare organizations. This study was guided by Toyota's theory of lean and Mintzberg's theory of management development to explain why the problem of medical supply waste exists. Government…

  9. Organising medication discontinuation: a qualitative study exploring the views of general practitioners toward discontinuing statins.

    Science.gov (United States)

    Nixon, Michael; Kousgaard, Marius Brostrøm

    2016-07-07

    Discontinuing medications is a complex decision making process and an important medical practice. It is a tool in reducing polypharmacy, reducing health system expenditure and improving patient quality of life. Few studies have looked at how general practitioners (GPs) discontinue a medication, in agreement with the patients, from a professional perspective. Three research questions were examined in this study: when does medication discontinuation occur in general practice, how is discontinuing medication handled in the GP's practice and how do GPs make decisions about discontinuing medication? Twenty four GPs were interviewed using a maximum variation sample strategy. Participant observations were done in three general practices, for one day each, totalling approximately 30 consultations. The results show that different discontinuation cues (related to the type of consultation, medical records and the patient) create situations of dissonance that can lead to the GP considering the option of discontinuation. We also show that there is a lot of ambiguity in situations of discontinuing and that some GPs trialled discontinuing as means of generating more information that could be used to deal with the ambiguity. We conclude that the practice of discontinuation should be conceptualised as a continually evaluative process and one that requires sustained reflection through a culture of systematically scheduled check-ups, routinely eliciting the patient's experience of taking drugs and trialling discontinuation. Some policy recommendations are offered including supporting GPs with lists or handbooks that directly address discontinuation and by developing more person centred clinical guidelines that discuss discontinuation more explicitly.

  10. An exploration of the biomedical optics course construction of undergraduate biomedical engineering program in medical colleges

    Science.gov (United States)

    Guo, Shijun; Lyu, Jie; Zhang, Peiming

    2017-08-01

    In this paper, the teaching goals, teaching contents and teaching methods in biomedical optics course construction are discussed. From the dimension of teaching goals, students should master the principle of optical inspection on the human body, diagnosis and treatment of methodology and instruments, through the study of the theory and practice of this course, and can utilize biomedical optics methods to solve practical problems in the clinical medical engineering practice. From the dimension of teaching contents, based on the characteristics of biomedical engineering in medical colleges, the organic integration of engineering aspects, medical optical instruments, and biomedical aspects dispersed in human anatomy, human physiology, clinical medicine fundamental related to the biomedical optics is build. Noninvasive measurement of the human body composition and noninvasive optical imaging of the human body were taken as actual problems in biomedical optics fields. Typical medical applications such as eye optics and laser medicine were also integrated into the theory and practice teaching. From the dimension of teaching methods, referencing to organ-system based medical teaching mode, optical principle and instrument principle were taught by teachers from school of medical instruments, and the histological characteristics and clinical actual need in areas such as digestive diseases and urinary surgery were taught by teachers from school of basic medicine or clinical medicine of medical colleges. Furthermore, clinical application guidance would be provided by physician and surgeons in hospitals.

  11. Exploring the uncharted territory of social media: the next frontier of medical education in nephrology.

    Science.gov (United States)

    Desai, Tejas; Sridharan, Sivakumar; Parada, Xavier; Claure-Del Granado, Rolando; Orantes, Carlos; Madariaga, Hector; Penmatsa, Krishnam Raju; Basu, Gopal; Arce Amare, Fernanda

    2018-04-01

    Social media is gaining popularity amongst both medical educators and life-long learners. One of the most popular social media platforms used by the medical community is Twitter, which is popular amongst physicians, students and patients, and particularly in medical societies. Major international and regional societies commonly use Twitter to amplify their reach beyond what their live annual meetings can achieve. There has been a unique and notable effort by Nephrology societies to craft a structured social media strategy that results in the broadest reach to the community of nephrology providers. We report on the first three such experiments performed by three separate nephrology organizations.

  12. "Yes, and …" Exploring the Future of Learning Analytics in Medical Education.

    Science.gov (United States)

    Cirigliano, Matt M; Guthrie, Charlie; Pusic, Martin V; Cianciolo, Anna T; Lim-Dunham, Jennifer E; Spickard, Anderson; Terry, Valerie

    2017-01-01

    This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Northeastern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of three experts who shared their thoughts stimulated by the study. Commentators brainstormed "what's next" with learning analytics in medical education, including advancements in interaction metrics and the use of interactivity analysis to deepen understanding of perceptual, cognitive, and social learning and transfer processes.

  13. "I Didn't Used to Have Much Friends": Exploring the Friendship Concepts and Capabilities of a Boy with Autism and Severe Learning Disabilities

    Science.gov (United States)

    Potter, Carol

    2015-01-01

    Whilst progress has been made in understanding the friendships of children with autism, research on the friendships of children with additional learning disabilities remains extremely limited. In this research, a qualitative case study approach provided a rich description of the friendship concepts and capabilities of Ben, a 10-year-old boy with…

  14. CASL Dakota Capabilities Summary

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Brian M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Simmons, Chris [Univ. of Texas, Austin, TX (United States); Williams, Brian J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-10-10

    The Dakota software project serves the mission of Sandia National Laboratories and supports a worldwide user community by delivering state-of-the-art research and robust, usable software for optimization and uncertainty quantification. These capabilities enable advanced exploration and riskinformed prediction with a wide range of computational science and engineering models. Dakota is the verification and validation (V&V) / uncertainty quantification (UQ) software delivery vehicle for CASL, allowing analysts across focus areas to apply these capabilities to myriad nuclear engineering analyses.

  15. Medical students volunteering in hospital: a novel method of exploring and recording the patient experience

    Directory of Open Access Journals (Sweden)

    Monica Lorraina Hytiris

    2017-05-01

    Full Text Available Background: Patient experience is increasingly recognised as an important feature of healthcare quality improvement. However, many of the methods implemented for its collection have significant limitations and reliability issues. This article describes how a UK healthcare organisation worked with medical student volunteers to build capacity for the collection of patient feedback in evidence-informed ways, and summarises student reflections on this process. Aims: To improve the quantity and quality of inpatient feedback, and in doing so provide new learning opportunities for medical students. Conclusions: Patient feedback gathered by volunteers is beneficial to the service and to medical student volunteers. As the feedback gathered is ward-specific, opportunities are created for practice improvements to be identified and acted on. It is feasible for medical students to be trained effectively as volunteers in gathering patient care experiences with adequate support mechanisms in place. Implications for practice: •\tHealthcare services should consider the use of personnel independent of the care team for the collection of patient feedback •\tPatient feedback needs to be shared with practitioners in a timely manner •\tMedical schools should consider this type of volunteering as a unique opportunity for medical students to improve understanding of patients’ experiences of healthcare, and of how care can be person-centred

  16. Capability approach

    DEFF Research Database (Denmark)

    Jensen, Niels Rosendal; Kjeldsen, Christian Christrup

    Lærebogen er den første samlede danske præsentation af den af Amartya Sen og Martha Nussbaum udviklede Capability Approach. Bogen indeholder en præsentation og diskussion af Sen og Nussbaums teoretiske platform. I bogen indgår eksempler fra såvel uddannelse/uddannelsespolitik, pædagogik og omsorg....

  17. A Qualitative Exploration of the Help-Seeking Behaviors of Students Who Experience Psychological Distress Around Assessment at Medical School.

    Science.gov (United States)

    Winter, Rachel I; Patel, Rakesh; Norman, Robert I

    2017-08-01

    Medical students are at high risk of experiencing psychological distress at medical school and developing mental ill-health during professional practice. Despite efforts by faculty to raise awareness about this risk, many students choose to suffer in silence in the face of psychological distress. The aim of this study was to explore drivers that prompted help-seeking behavior and barriers that prevented individuals prioritizing their well-being around the time of high-stakes assessment at medical school. Semi-structured interviews were conducted with fifty-seven students who failed high-stakes assessment at two UK medical schools, exploring their experience of academic difficulty and perceptions about causes. A thematic analysis of twenty transcripts that met inclusion criteria was completed to identify key factors that influenced participants' decisions around seeking help for their psychological distress, and in some cases, mental health problems. Twenty participants who specifically described a deterioration in their mental health around the time of assessment were included in this study. Barriers to seeking help in these instances included: normalization of symptoms or situation; failure to recognize a problem existed; fear of stigmatisation; overt symptoms of mental distress; and misconceptions about the true nature of the medical school, for example beliefs about a punitive response from the school if they failed. Drivers for seeking help appropriately included: building trust with someone in order to confide in them later on, and self-awareness about the need to maintain good mental health. There are various drivers and barriers for students' help seeking behaviors when experiencing psychological distress around the time of assessment, particularly self-awareness about the problem and prioritisation of well-being. Students who fail to recognize their own deteriorating mental health are at risk of academic failure and medical schools need to develop

  18. Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

    Directory of Open Access Journals (Sweden)

    Ephrem Abebe

    2018-02-01

    Full Text Available Objective: To describe challenges associated with the medication use process and potential medication safety hazards in an Ethiopian hospital emergency department using a human factors approach. Methods: We conducted a qualitative study employing observations and semi-structured interviews guided by the Systems Engineering Initiative for Patient Safety model of work system as an analytical framework. The study was conducted in the emergency department of a teaching hospital in Ethiopia. Study participants included resident doctors, nurses, and pharmacists. We performed content analysis of the qualitative data using accepted procedures. Results: Organizational barriers included communication failures, limited supervision and support for junior staff contributing to role ambiguity and conflict. Compliance with documentation policy was minimal. Task related barriers included frequent interruptions and work-related stress resulting from job requirements to continuously prioritize the needs of large numbers of patients and family members. Person related barriers included limited training and work experience. Work-related fatigue due to long working hours interfered with staff’s ability to document and review medication orders. Equipment breakdowns were common as were non-calibrated or poorly maintained medical devices contributing to erroneous readings. Key environment related barriers included overcrowding and frequent interruption of staff’s work. Cluttering of the work space compounded the problem by impeding efforts to locate medications, medical supplies or medical charts. Conclusions: Applying a systems based approach allows a context specific understanding of medication safety hazards in EDs from low-income countries. When developing interventions to improve medication and overall patient safety, health leaders should consider the interactions of the different factors. Conflict of Interest We declare no conflicts of interest or

  19. Health aspects of Arctic exploration – Alaska's medical history based on the research files of Dr. Robert Fortuine

    Directory of Open Access Journals (Sweden)

    Kathleen Murray

    2013-08-01

    Full Text Available Background . Robert Fortuine provided basic medical care to Alaska Native people, chronicled the Health Aspects of Arctic Exploration and through a number of influential publications, was the first to thoroughly document and analyse Alaska's Medical History. This overview of his published work will provide the reader with a detailed overview, so that they can begin to explore Dr. Fortuine's many published works in more detail. Objective . This review will explore Alaska's Medical History and the Health Aspects of Arctic Exploration through the research files and the 10 most significant publications of Dr. Robert Fortuine. Design . Review of Dr. Fortuine's major works and the master bibliography has over 3,000 references and 81 subjects. The master bibliography is a merger of 55 separate bibliographies, which provides a wealth of bibliographic information. This paper will describe his 10 most significant publications, 2 of which began as a journal issue. Results . Dr. Fortuine was a prolific writer throughout his career, publishing 134 articles and books. He wrote papers and books on Alaska's medical history, tuberculosis and health care delivery from Russian–America through the Public Health Service efforts in the territory and then the State of Alaska. The master bibliography has over 3,000 references and 81 subjects. This list has a significant number of entries for tuberculosis with almost one-third of the entries including this heading. Others dwell on the history of “pre-contact” health, the history of Alaska Native health care, the history of the Alaska Department of Health, especially the tuberculosis programme, the role of the US Public Health Service and traditional medicine. He completely reviewed every Governors’ and the US Surgeon General's reports in regard to Alaska content. This paper describes his 10 most significant publications. Conclusions . Robert Fortuine's published works offer a wealth of information and insight

  20. Exploring the Unmet Needs of the Patient in the Outpatient Respiratory Medical Clinic

    DEFF Research Database (Denmark)

    Jensen, Lone Birgitte; Brinkkjær, Ulf; Larsen, Kristian

    2015-01-01

    Aim. Developing a theoretical framework explaining patients’ behaviour and actions related to unmet needs during interactions with health care professionals in hospital-based outpatient respiratory medical clinics. Background. The outpatient respiratory medical clinic plays a prominent role in many...... patients’ lives regarding treatment and counselling increasing the need for a better understanding of patients’ perspective to the counselling of the health care professionals. Design. The study is exploratory and based on Charmaz’s interpretation of grounded theory. Methods. The study included 65 field...... observations with a sample of 43 patients, 11 doctors, and 11 nurses, as well as 30 interviews with patients, conducted through theoretical sampling from three outpatient respiratory medical clinics in Denmark. Findings. The patients’ efforts to share their significant stories triggered predominantly...

  1. Sea, sun, sand and …. selecting surgery: an exploration of health, medical and wellness tourist's mobility

    Directory of Open Access Journals (Sweden)

    Robert S. Bristow

    2015-11-01

    Full Text Available Mass tourism facilities depend on repeat visitors as well as attracting new first time tourists. As these traditional sun and sand holiday destinations mature, tourism promoters are bundling opportunities to attract a different kind of tourist. Since many of these resorts are all-inclusive facilities and include a Spa, one potential expansion may be to market to health, medical or wellness tourists. Geographic research in travel and tourism has found that individuals either repeat visits to the same destination or diversify their choices. This paper highlights the decision-making process of tourists and how it may be related to the niche market of health, wellness, and medical tourism. It uses data from a survey that gathered the travel patterns and motivations, and socio-demographics of medical tourists. Consumers who exhibit different travel behavior rank hospital accreditation and American hospital affiliation more important than those who repeat travel behavior

  2. Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

    Directory of Open Access Journals (Sweden)

    Melissa L. Mugambi

    2017-01-01

    Full Text Available In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs. Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI. Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI.

  3. Medical Students' Development of Ethical Judgment - Exploring the Learners' Perspectives using a mixed methods approach.

    Science.gov (United States)

    Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W

    2016-01-01

    Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students' perspectives on their development in ethical judgment has received less attention. Better insights in the learners' experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient's parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant's preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants' responses changed overtime. Accepting parents' autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents' decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical training, the

  4. Medical Students’ Development of Ethical Judgment – Exploring the Learners’ Perspectives using a mixed methods approach

    Science.gov (United States)

    Langer, Thorsten; Jazmati, Danny; Jung, Ole; Schulz, Christian; Schnell, Martin W.

    2016-01-01

    Objective: Contemporary healthcare requires physicians to have well developed ethical judgment skills in addition to excellent clinical skills. However, no consensus has been reached on how to best teach ethical judgment skills during medical training. Previous studies revealed inconclusive results and applied varying theoretical frameworks. To date, the students’ perspectives on their development in ethical judgment has received less attention. Better insights in the learners’ experiences can help to improve educational interventions in medical ethics. Methods: A vignette featuring a challenging case with opposing views between a patient’s parents and a physician followed by a questionnaire was presented to a cohort of medical students at a German medical school at three points in time during their medical training (Year 1, 2 and 5). The questionnaire included closed and open-ended questions addressing the participant’s preferred, hypothetical actions, their reasoning as well as the resources informing their reasoning. Content analysis was used for qualitative data; frequencies and percentages were used to describe quantitative findings. Results: The response rate remained stable (28%) over the study period. Participants’ responses changed overtime. Accepting parents’ autonomy in the decision-making process was the majority standpoint of students in year 1 and 2 and became less often cited in year 5 (Year 1/2/5: 68/67/48%). On the contrary, not readily following the parents’ decision for medical reasons was a minority standpoint in year 1 and became more prevalent over time (year 1/2/5: 12/17/42%). Judgments were only partly based on ethics training. Instead, participants drew on experiences from their clinical clerkships and their personal lives. Throughout the study, participants did not feel well-prepared to make a judgment in the case (Average 2.7 on a Likert-Scale; 1=very well prepared, 4=very poor). Conclusions: Over the course of their medical

  5. The future of practical skills in undergraduate medical education - an explorative Delphi-Study.

    Science.gov (United States)

    Dannenberg, Katja Anne; Stroben, Fabian; Schröder, Therese; Thomas, Anke; Hautz, Wolf E

    2016-01-01

    64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of "outcome-orientated training" is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs) are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM) - the German OF - the "Consensus Statement of Practical Skills in Undergraduate Medical Education" (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the "Clinical-Practical Skills" chapter of the NKLM) was published in 2011. It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students' graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF. Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim. 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of the consensus statement, 231 of the goals were assessed as relevant

  6. The future of practical skills in undergraduate medical education – an explorative Delphi-Study

    Directory of Open Access Journals (Sweden)

    Dannenberg, Katja Anne

    2016-08-01

    Full Text Available Background: 64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of “outcome-orientated training” is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM – the German OF – the “Consensus Statement of Practical Skills in Undergraduate Medical Education” (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the “Clinical-Practical Skills” chapter of the NKLM was published in 2011.It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students’ graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF. Methodology: Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim. Results: 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of

  7. Exploring behavioural determinants relating to health professional reporting of medication errors: a qualitative study using the Theoretical Domains Framework.

    Science.gov (United States)

    Alqubaisi, Mai; Tonna, Antonella; Strath, Alison; Stewart, Derek

    2016-07-01

    Effective and efficient medication reporting processes are essential in promoting patient safety. Few qualitative studies have explored reporting of medication errors by health professionals, and none have made reference to behavioural theories. The objective was to describe and understand the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE). This was a qualitative study comprising face-to-face, semi-structured interviews within three major medical/surgical hospitals of Abu Dhabi, the UAE. Health professionals were sampled purposively in strata of profession and years of experience. The semi-structured interview schedule focused on behavioural determinants around medication error reporting, facilitators, barriers and experiences. The Theoretical Domains Framework (TDF; a framework of theories of behaviour change) was used as a coding framework. Ethical approval was obtained from a UK university and all participating hospital ethics committees. Data saturation was achieved after interviewing ten nurses, ten pharmacists and nine physicians. Whilst it appeared that patient safety and organisational improvement goals and intentions were behavioural determinants which facilitated reporting, there were key determinants which deterred reporting. These included the beliefs of the consequences of reporting (lack of any feedback following reporting and impacting professional reputation, relationships and career progression), emotions (fear and worry) and issues related to the environmental context (time taken to report). These key behavioural determinants which negatively impact error reporting can facilitate the development of an intervention, centring on organisational safety and reporting culture, to enhance reporting effectiveness and efficiency.

  8. ENTREPRENEURIAL CAPABILITIES

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard; Nielsen, Thorkild

    2003-01-01

    The aim of this article is to analyse entrepreneurship from an action research perspective. What is entrepreneurship about? Which are the fundamental capabilities and processes of entrepreneurship? To answer these questions the article includes a case study of a Danish entrepreneur and his networ....... Finally, the article discuss, how more long term action research methods could be integrated into the entrepreneurial processes and the possible impacts of such an implementation?...

  9. Improving Provenance Data Interaction for Visual Storytelling in Medical Imaging Data Exploration

    NARCIS (Netherlands)

    Amabili, L.; Kosinka, J.; van Meersbergen, M.A.J.; van Ooijen, P. M. A.; Roerdink, J. B. T. M.; Svetachov, P.; Yu, L.; Johansson, Jimmy; Sadlo, Filip; Schreck, Tobias

    2018-01-01

    Effective collaborative work in diagnostic medical imaging is not trivial due to the large amounts of complex data involved, a (non-linear) workflow involving experts in different domains, and a lack of versatility in the current tools employed in healthcare. In this paper, we aim to introduce how

  10. Exploring the potential of video technologies for collaboration in emergency medical care

    DEFF Research Database (Denmark)

    Sonnenwald, Diane H.; Söderholm, Hanna M.; Manning, James E.

    2008-01-01

    videoconferencing techniques. This may be of benefit in diagnosing and treating patients in emergency situations where specialized medical expertise is not locally available. The 3D telepresence technology does not yet exist, and there is a need to understand its potential before resources are spent on its...

  11. Data Mining and Domain Knowledge: An Exploration of Methods to Advance Medical Research

    Science.gov (United States)

    Engle, Kelley M.

    2013-01-01

    Researchers in the medical domain consider the double-blind placebo controlled clinical trial the gold standard. The data for these clinical trials are collected for a specifically defined hypothesis and there is very little in the realm of secondary data analyses conducted. The underlying purpose of this work is to demonstrate the value and…

  12. Incorporating E-learning in teaching English language to medical students: exploring its potential contributions

    Science.gov (United States)

    Navidinia, Hossein; Zare Bidaki, Majid; Hekmati, Nargess

    2016-01-01

    Background: The spread of technology has influenced different aspects of human life, and teaching and learning are not exceptions. This study aimed to examine the potential contribution of the use of technology in teaching English language to medical students. Methods: This qualitative-action research study was conducted in Birjand University of Medical Sciences (BUMS), with 60 medical students taking a general English course in the Fall Semester of 2015. The class favored different tools and multimedia facilities such as a tube channel, e-dictionaries, educational films, and etextbooks to enhance students’ learning. In addition, the class had a weblog in which students could upload assignments and receive feedback from peers and the instructors. Results: The results revealed that e-learning could enhance students’ language proficiency and facilitate the teaching process. Learners preferred to use more e-dictionaries to learn the meaning of the new words, watch English medical films to boost their speaking and listening skills, and use the electronic version of their textbook as they could carry it wherever they wanted. Conclusion: The students preferred this method of learning English as they became more independent by using the electronic facilities. They found that learning English did not have a fixed institutionalized method, and e-learning activities could provide them with authentic input for language learning even outside of the classroom. PMID:28491837

  13. Resetting the compass: exploring the implicit messages of orientation to a community-engaged medical school

    Directory of Open Access Journals (Sweden)

    Rachel Helen Ellaway

    2017-02-01

    Conclusion: Orientation to undergraduate medical training can be successfully linked to a school’s social mission, but in doing so it can send complex and unintended messages to the participants that may be perceived quite differently based on their circumstances and expectations.

  14. Exploring the potential uses of value-added metrics in the context of postgraduate medical education.

    Science.gov (United States)

    Gregory, Simon; Patterson, Fiona; Baron, Helen; Knight, Alec; Walsh, Kieran; Irish, Bill; Thomas, Sally

    2016-10-01

    Increasing pressure is being placed on external accountability and cost efficiency in medical education and training internationally. We present an illustrative data analysis of the value-added of postgraduate medical education. We analysed historical selection (entry) and licensure (exit) examination results for trainees sitting the UK Membership of the Royal College of General Practitioners (MRCGP) licensing examination (N = 2291). Selection data comprised: a clinical problem solving test (CPST); a situational judgement test (SJT); and a selection centre (SC). Exit data was an applied knowledge test (AKT) from MRCGP. Ordinary least squares (OLS) regression analyses were used to model differences in attainment in the AKT based on performance at selection (the value-added score). Results were aggregated to the regional level for comparisons. We discovered significant differences in the value-added score between regional training providers. Whilst three training providers confer significant value-added, one training provider was significantly lower than would be predicted based on the attainment of trainees at selection. Value-added analysis in postgraduate medical education potentially offers useful information, although the methodology is complex, controversial, and has significant limitations. Developing models further could offer important insights to support continuous improvement in medical education in future.

  15. Incorporating E-learning in teaching English language to medical students: exploring its potential contributions.

    Science.gov (United States)

    Navidinia, Hossein; Zare Bidaki, Majid; Hekmati, Nargess

    2016-01-01

    Background: The spread of technology has influenced different aspects of human life, and teaching and learning are not exceptions. This study aimed to examine the potential contribution of the use of technology in teaching English language to medical students. Methods: This qualitative-action research study was conducted in Birjand University of Medical Sciences (BUMS), with 60 medical students taking a general English course in the Fall Semester of 2015. The class favored different tools and multimedia facilities such as a tube channel, e-dictionaries, educational films, and etextbooks to enhance students' learning. In addition, the class had a weblog in which students could upload assignments and receive feedback from peers and the instructors. Results: The results revealed that e-learning could enhance students' language proficiency and facilitate the teaching process. Learners preferred to use more e-dictionaries to learn the meaning of the new words, watch English medical films to boost their speaking and listening skills, and use the electronic version of their textbook as they could carry it wherever they wanted. Conclusion: The students preferred this method of learning English as they became more independent by using the electronic facilities. They found that learning English did not have a fixed institutionalized method, and e-learning activities could provide them with authentic input for language learning even outside of the classroom.

  16. Exploration of a leadership competency model for medical school faculties in Korea.

    Science.gov (United States)

    Lee, Yong Seok; Oh, Dong Keun; Kim, Myungun; Lee, Yoon Seong; Shin, Jwa Seop

    2010-12-01

    To adapt to rapid and turbulent changes in the field of medicine, education, and society, medical school faculties need appropriate leadership. To develop leadership competencies through education, coaching, and mentoring, we need a leadership competency model. The purpose of this study was to develop a new leadership competency model that is suitable for medical school faculties in Korea. To collect behavioral episodes with regard to leadership, we interviewed 54 subjects (faculties, residents, nurses) and surveyed 41 faculties with open-ended questionnaires. We classified the behavioral episodes based on Quinn and Cameron's leadership competency model and developed a Likert scale questionnaire to perform a confirmatory factor analysis. Two hundred seven medical school faculties responded to the questionnaire. The competency clusters that were identified by factor analysis were professionalism, citizenship, leadership, and membership to an organization. Accordingly, each cluster was linked with a dimension: self, society, team (that he/she is leading), and organization (to which he/she belongs). The clusters of competencies were: professional ability, ethics/morality, self-management, self-development, and passion; public interest, networking, social participation, and active service; motivating, caring, promoting teamwork, nurturing, conflict management, directing, performance management, and systems thinking; organizational orientation, collaboration, voluntary participation, and cost-benefit orientation. This competency model that fits medical school faculties in Korea can be used to design and develop selection plans, education programs, feedback tools, diagnostic evaluation tools, and career plan support programs.

  17. Exploring individual user differences in the 2D/3D interaction with medical image data

    NARCIS (Netherlands)

    Zudilova-Seinstra, E.; van Schooten, B.; Suinesiaputra, A.; van der Geest, R.; van Dijk, B.; Reiber, J.; Sloot, P.

    2010-01-01

    User-centered design is often performed without regard to individual user differences. In this paper, we report results of an empirical study aimed to evaluate whether computer experience and demographic user characteristics would have an effect on the way people interact with the visualized medical

  18. Exploring individual user differences in the 2D/3D interaction with medical image data

    NARCIS (Netherlands)

    Zudilova-Seinstra, Elena; van Schooten, B.W.; Suinesiaputra, Avan; van der Geest, Rob; van Dijk, Elisabeth M.A.G.; Reiber, Johan; Sloot, Peter

    2009-01-01

    User-centered design is often performed without regard to individual user differences. In this paper, we report results of an empirical study aimed to evaluate whether computer experience and demographic user characteristics would have an effect on the way people interact with the visualized medical

  19. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups.

    Science.gov (United States)

    Yan, Yu-Hua; Kung, Chih-Ming; Chen, Yi

    2017-11-09

    This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs) on medical resource utilization in inguinal hernia repair (IHR) in hospitals with different ownership to provide suitable reference information for hospital administrators. The 2010-2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case) was more efficient than that in the public hospital (US$902.7/case) or nonprofit proprietary hospital (US$817.1/case) surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%), while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  20. The exploration of medical resources utilization among inguinal hernia repair in Taiwan diagnosis-related groups

    Directory of Open Access Journals (Sweden)

    Yu-Hua Yan

    2017-11-01

    Full Text Available Abstract Background This study centered on differences in medical costs, using the Taiwan diagnosis-related groups (Tw-DRGs on medical resource utilization in inguinal hernia repair (IHR in hospitals with different ownership to provide suitable reference information for hospital administrators. Methods The 2010–2011 data for three hospitals under different ownership were extracted from the Taiwan National Health Insurance claims database. A retrospective method was applied to analyze the age, sex, length of stay, diagnosis and surgical procedure code, and the change in financial risk of medical costs in IHR cases after introduction of Tw-DRGs. The study calculated the cost using Tw-DRG payment principles, and compared it with estimated inpatient medical costs calculated using the fee-for-service policy. Results There were 723 IHR cases satisfying the Tw-DRGs criteria. Cost control in the medical care corporation hospital (US$764.2/case was more efficient than that in the public hospital (US$902.7/case or nonprofit proprietary hospital (US$817.1/case surveyed in this study. For IHR, anesthesiologists in the public hospital preferred to use general anesthesia (86%, while those in the two other hospitals tended to administer spinal anesthesia. We also discovered the difference in anesthesia cost was high, at US$80.2/case on average. Conclusions Because the Tw-DRG-based reimbursement system produces varying hospital costs, hospital administrators should establish a financial risk assessment system as early as possible to improve healthcare quality and financial management efficiency. This would then benefit the hospital, patient, and Bureau of National Health Insurance.

  1. Exploring Clinical Rotation Competence Improvements after Interpersonal Skills Development in At-Risk Medical Students

    Directory of Open Access Journals (Sweden)

    Sri Linuwih Menaldi

    2014-12-01

    Full Text Available AbstractPrior to admission, medical students were subject to psychological tests to measure their logical thinking skills and personality, hence predicting their ability to complete their studies. The results showed 56,45% of medical students obtained recommendation category 4 (doubtful and 5 (not recommended, two categories which are considered to be at-risk group with a very small probability of completing their studies. These results predicted that students in the mentioned groups will have difficulties in achieving the clinical competence level required by the Indonesian Doctors’ Competency Standard (IDCS. The aim of the study was to investigate clinical competency achievement by at-risk medical students in the third year, after following interpersonal skills development training program on July 2011. This research used qualitative study design through psychological examination, written self-reflection and in-depth interview after the training. Interpersonal skills development training for at-risk medical students gave positive effects to theircharacter development for the helping profession. It was concluded that interpersonal skills training could help improve medical student’s achievement of clinical competence especially for at-risk group in their clinical rotations stage.Keywords: medical students, at-risk group, interpersonal skills, clinical competence AbstrakPada mahasiswa kedokteran yang baru masuk dilakukan pemeriksaan psikologis untuk memperoleh gambaran penalaran dan kepribadian untuk memprediksi kemampuan mahasiswa dalam menyelesaikan pendidikan. Berdasarkan pemeriksaan tersebut diperoleh 56,45% mahasiswa dengan hasil uji psikometrik kategori rekomendasi 4 (diragukan dan 5 (tidak disarankan yang disebut sebagai kelompok at-risk. Kelompok at risk memiliki peluang keberhasilan rendah untuk menyelesaikan pendidikan dan akan mengalami kesulitan mencapai kompetensi klinik sesuai Standar Kompetensi Dokter Indonesia. Tujuan

  2. Capabilities for Intercultural Dialogue

    Science.gov (United States)

    Crosbie, Veronica

    2014-01-01

    The capabilities approach offers a valuable analytical lens for exploring the challenge and complexity of intercultural dialogue in contemporary settings. The central tenets of the approach, developed by Amartya Sen and Martha Nussbaum, involve a set of humanistic goals including the recognition that development is a process whereby people's…

  3. Beyond good and evil: exploring medical trainee use of social media.

    Science.gov (United States)

    George, Daniel R; Green, Michael J

    2012-01-01

    Medicine has struggled to integrate a new generation of social media technologies. Rather than focusing on the promise of these emerging tools, the academic literature is replete with admonishments of how social media pose a danger to medical professionals, and guidelines regarding social media are written with expectations of misuse rather than consideration of positive application. To better learn how new technology might be integrated into professional lives, it is imperative to seek perspectives from younger trainees who have already begun navigating the unique professional and ethical dilemmas posed by social media and might assist in identifying innovative uses of existing tools. The views and practices of current trainees can provide important insight into the proactive role social media can play in the delivery of more effective health care during an era in which social media usage is invariably increasing for medical professionals and patients.

  4. Exploring the possibility for business model innovation in Laerdal Medical using Virtual Reality

    OpenAIRE

    Ullestad, Freddie; Søndenaa, Thomas

    2017-01-01

    Master's thesis in Business administration: Executive MBA The purpose of this paper is to check how Virtual Reality patient simulation as a disruptive technology may give opportunities for established companies, such as Laerdal Medical, to create innovative business models in the nursing and healthcare education market. The goal of the new and innovative business model would be to maintain and further strengthen existing business, when faced with threats from established and potential new ...

  5. High altitude medicine education in China: exploring a new medical education reform.

    Science.gov (United States)

    Luo, Yongjun; Luo, Rong; Li, Weiming; Huang, Jianjun; Zhou, Qiquan; Gao, Yuqi

    2012-03-01

    China has the largest plateau in the world, which includes the whole of Tibet, part of Qinghai, Xinjiang, Yunnan, and Sichuan. The plateau area is about 257.2×10(4) km(2), which accounts for about 26.8% of the total area of China. According to data collected in 2006, approximately twelve million people were living at high altitudes, between 2200 to 5200 m high, on the Qinghai-Tibetan Plateau. Therefore, there is a need for medical workers who are trained to treat individuals living at high altitudes. To train undergraduates in high altitude medicine, the College of High Altitude Military Medicine was set up at the Third Military Medical University (TMMU) in Chongqing in 1999. This is the only school to teach high altitude medicine in China. Students at TMMU study natural and social sciences, basic medical sciences, clinical medical sciences, and high altitude medicine. In their 5(th) year, students work as interns at the General Hospital of Tibet Military Command in Lhasa for 3 months, where they receive on-site teaching. The method of on-site teaching is an innovative approach for training in high altitude medicine for undergraduates. Three improvements were implemented during the on-site teaching component of the training program: (1) standardization of the learning progress; (2) integration of formal knowledge with clinical experience; and (3) coaching students to develop habits of inquiry and to engage in ongoing self-improvement to set the stage for lifelong learning. Since the establishment of the innovative training methods in 2001, six classes of high altitude medicine undergraduates, who received on-site teaching, have graduated and achieved encouraging results. This evidence shows that on-site teaching needs to be used more widely in high altitude medicine education.

  6. Sea, sun, sand and …. selecting surgery: an exploration of health, medical and wellness tourist's mobility

    OpenAIRE

    Robert S. Bristow; Wen-Tsann Yang

    2015-01-01

    Mass tourism facilities depend on repeat visitors as well as attracting new first time tourists. As these traditional sun and sand holiday destinations mature, tourism promoters are bundling opportunities to attract a different kind of tourist. Since many of these resorts are all-inclusive facilities and include a Spa, one potential expansion may be to market to health, medical or wellness tourists. Geographic research in travel and tourism has found that individuals either repeat visits to t...

  7. Serving an Indigenous community: Exploring the cultural competence of medical students in a rural setting

    Directory of Open Access Journals (Sweden)

    Chin Hoong Wong

    2017-06-01

    Full Text Available Since 2013, medical students from the International Medical University (IMU in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses. Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process. The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural

  8. Exploring UK medical and social work students' legal literacy: comparisons, contrasts and implications.

    Science.gov (United States)

    Preston-Shoot, Michael; McKimm, Judy

    2013-05-01

    To ensure acceptable practice standards both doctors and social workers should draw on relevant legal rules when reaching professional judgements concerning, for instance, children requiring protection, people with severe mental distress and adults at risk, information sharing, consent to intervention and service user involvement in their care and treatment. Many practitioners use the law to maintain high standards of professionalism. However, research has uncovered limited awareness of legal rules and poor standards of health and social care. Academic benchmarks and practice requirements for health and social care professions centrally position legal knowledge for secure decision-making. Model curricula exist. However, the outcomes of the taught curriculum on students' confidence in their legal knowledge and skills have been relatively overlooked. This article introduces the concept of legal literacy, a distillation of knowledge, understanding, skills and values that enables practitioners to connect relevant legal rules with their professional practice, to appreciate the roles and duties of other practitioners and to communicate effectively across organisational boundaries. It presents the outcomes for a 2006-2009 study of 1154 UK medical and 638 social work students of their law learning for practice, response rates of 46% and 68%. Significant differences were found between medical and social work students' attitudes towards the law, and in their self-ratings of legal knowledge and skills. Confidence levels were low and anxiety high, especially among medical students, although law teaching had some positive outcomes on knowledge and skill development. Social work and medical students associated different themes with the law, the latter especially foregrounding ethics, negligence and liability, which could affect inter-professional working. Students are not fully prepared for legally literate practice, with a consequent need to review the time allocated for, and

  9. Behaviour of medical students in seeking mental and physical health care: exploration and comparison with psychology students.

    Science.gov (United States)

    Brimstone, Renee; Thistlethwaite, Jill E; Quirk, Frances

    2007-01-01

    Doctors are often reluctant to seek health care through the usual channels and tend to self-diagnose and prescribe. Medical students learn attitudes and values from clinician role models and may also adopt behaviour patterns that lead them to seek help for physical and mental health problems from informal sources. This study aimed to explore the behaviour of students in seeking health care for physical and mental health problems, comparing medical with psychology students, and to understand what barriers to conventional routes of seeking health care may affect this. We administered a questionnaire asking for demographic details and responses to 2 vignettes in which a student from the respondent's discipline was experiencing firstly symptoms of a mental health problem and secondly symptoms of a physical health problem. Data were analysed with spss and univariate anovas to examine differences between respondents. A total of 172 students at the psychology and medical schools at James Cook University in Australia participated. We identified a number of barriers affecting student behaviour in seeking help, which included worries about knowing the doctor they could consult at the university health centre or having future dealings with him or her, and cost of treatment. There were differences between the 2 groups of students. There are several barriers for both psychology and medical students to accessing appropriate professional mental health care. Medical students also experience barriers to attaining appropriate physical health care when needed. Psychology and medical students were more likely to seek advice informally from friends and/or family with regard to mental health care.

  10. Practice Report / Bericht aus der Praxis: An exploration of peer tutor roles and recruitment at German medical schools.

    Science.gov (United States)

    Alvarez, Simone; Schultz, Jobst-Hendrik

    2017-11-01

    Almost all medical faculties in Germany actively employ peer tutors. However, little is known about the roles these tutors play from a faculty point of view. Also, there are only few descriptions of the tutor recruitment and selection processes. 32 of the medical faculties in Germany, where tutors are used in the training of medical students, were asked to provide information on the role and recruitment of tutors by means of a partially standardized questionnaire. At the surveyed faculties (return rate 28%), tutors are mostly employed for the purpose of teaching staff support. Even though desired in individual cases, tutors rarely play an active role in curriculum- or faculty development. The way tutor recruitment is handled strongly depends on the capabilities of the individual faculties and the way tutors are utilized. In many cases this process is structured, consisting of written and oral application phases, in other cases recruitment takes place without formal application procedures. The selection criteria, however, were found to be very similar at most faculties. The role of tutors from the faculties' point of view depends strongly on the respective nature of the tutorials, which are just as diverse as the approaches to tutor recruitment. Copyright © 2017. Published by Elsevier GmbH.

  11. Exploring the ideas and expectations of German medical students towards career choices and the speciality of psychiatry.

    Science.gov (United States)

    Baller, Frauke A E; Ludwig, Karin V; Kinas-Gnadt Olivares, Clara L; Graef-Calliess, Iris-Tatjana

    2013-08-01

    The aim of this study was to explore the ideas and expectations of medical students toward their career choices and the speciality of psychiatry. A total of 323 students of the Hannover Medical School filled in a questionnaire about their career choices, preferred medical specialization, factors of influence on career choices and attitude towards psychiatry. The three most important factors of influence appeared to be: (1) work-life balance, (2) flexible working hours, (3) career prospects. Although expectations towards the professional life of psychiatrists were quite positive among the students, there was only a small number of students (n = 53 of 318 respondents, 17%) interested in specializing in psychiatry. Important reasons for choosing psychiatry included personal experience with somatic or mental health issues and practical experience in psychiatry. Most of the students experienced clinical exposure to psychiatry but at a much later period in the curriculum. For a career choice of psychiatry as a speciality it seems to be important to start psychiatric education in medical school early. The positive aspects of the professional life in psychiatry, such as flexible working hours, career prospects and good work-life balance should be more emphasized.

  12. Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors.

    Science.gov (United States)

    Edge, Rhiannon; Goodwin, Dawn; Isba, Rachel; Keegan, Thomas

    2017-11-01

    The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants' previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual's opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination-there is potential to increase vaccination coverage.

  13. Medical Data Architecture Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2018-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

  14. Factors influencing the perception of roughness in manual exploration: Do medical gloves reduce cutaneous sensibility?

    OpenAIRE

    Mylon, P.T.; Buckley-Johnstone, L.; Lewis, R.; Carre, M.J.; Martin, N.

    2015-01-01

    A new roughness perception test was designed to evaluate cutaneous sensibility. Blindfolded subjects explored a sample of sandpaper using one of two methods: stroking the sample (dynamic method) or applying pressure (static method). A range of samples of various grades were presented in a random order, and subjects scored each one in terms of perceived roughness. Each subject performed the test in three conditions – wearing latex and nitrile examination gloves and bare-handed. Mean normalised...

  15. Unpacking dynamic capability : a design perspective

    NARCIS (Netherlands)

    Mulders, D.E.M.; Romme, A.G.L.; Bøllingtoft, A.; Håkonsson, D.D.; Nielsen, J.F.; Snow, C.C; Ulhøi, J.

    2009-01-01

    This chapter reviews the dynamic capability literature to explore relationships between definition, operationalization, and measurement of dynamic capability. Subsequently, we develop a design-oriented approach toward dynamic capability that distinguishes between design rules, recurrent patterns of

  16. Exploration of preferred learning styles in medical education using VARK modal

    Directory of Open Access Journals (Sweden)

    Laxman Khanal

    2014-09-01

    Full Text Available Learning styles is a term used to refer to the methods of gathering, processing, interpreting, organizing and thinking about information. Students have different learning styles, which is the reason for the diversity seen in classrooms in regards to how students acquire information. Claxton and Murrell had divided the learning styles into the following four categories: personality models, information-processing models, social-interaction models, and instructional preferences models. VARK (an acronym for Visual, Aural, Read/write and Kinesthetic, different way of learning styles is a learning inventory categorized into the ‘instructional preference’ modal. Many studies were done using the VARK inventory among the medical education but the preferred mode of learning was variable in different parts of the world. The relationship of age, gender and academic performance with the mode of learning was also not consistent. So this article tried to conclude the preferred mode of learning and relationship of mode of learning with gender and other factors by analyzing the previous studies done using VARK questionnaire among the medical students in daily teaching and learning environment. Pub Med and Google Scholar were used as a search engine to find the article. Altogether 20 full text research papers were retrieved and reviewed. In the most of part of the world the studies showed that multimodal learning style was the predominant one over unimodal. Further in multimodal quadmodal was the most preferred one followed by other presentation. In the unimodal presentation most preferred one is kinesthetic type of learning along with visual, aural and read write in less extent. Age factors had no lucid relationship with the learning style though some variations were observed with age.This review was expected to be useful as scientific evidence in the field of medical education and also as a reference for further research.

  17. Exploration of the perceptions of emergency physicians and interns regarding the medical documentation practices of interns.

    Science.gov (United States)

    Isoardi, Jonathon; Spencer, Lyndall; Sinnott, Michael; Nicholls, Kim; O'Connor, Angela; Jones, Fleur

    2013-08-01

    The primary objective of the present study was to learn the factors that influence the documentation practices of ED interns. A second objective was to identify the expectations of emergency physicians (EPs) towards the medical record documentation of ED interns. A qualitative design was adopted using semi-structured interviews in convenience samples drawn from both groups. Eighteen interviews were conducted with intern volunteers and 10 with EP volunteers. One (5%) intern and two (20%) EPs had received medical documentation training. Factors that encouraged interns' documentation included: patient acuity (the more critical the condition, the more comprehensive the documentation) and the support of senior colleagues. Inhibiting factors included uncertainty about how much to write, and the shift being worked (interns indicated they wrote less at night). Factors of consequence to senior personnel included the apparent reluctance of interns to document management plans. They noted that interns frequently confine their notes to assessment, investigations and treatments, whereas EPs preferred records that demonstrated intern thought processes and included such matters as future actions to follow immediate treatment. A positive theme that emerged included the high level of support interns received from their senior colleagues. Another theme, the influence of patient acuity, held both positive and negative implications for intern writing practices. The lack of formal training is an impediment to the production of useful medical records by ED interns. One solution proposed by both interns and senior personnel was the introduction of the subject into intern education programmes. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. Exploring virtual worlds for scenario-based repeated team training of cardiopulmonary resuscitation in medical students.

    Science.gov (United States)

    Creutzfeldt, Johan; Hedman, Leif; Medin, Christopher; Heinrichs, Wm LeRoy; Felländer-Tsai, Li

    2010-09-03

    Contemporary learning technologies, such as massively multiplayer virtual worlds (MMVW), create new means for teaching and training. However, knowledge about the effectiveness of such training is incomplete, and there are no data regarding how students experience it. Cardiopulmonary resuscitation (CPR) is a field within medicine in high demand for new and effective training modalities. In addition to finding a feasible way to implement CPR training, our aim was to investigate how a serious game setting in a virtual world using avatars would influence medical students' subjective experiences as well as their retention of knowledge. An MMVW was refined and used in a study to train 12 medical students in CPR in 3-person teams in a repeated fashion 6 months apart. An exit questionnaire solicited reflections over their experiences. As the subjects trained in 4 CPR scenarios, measurements of self-efficacy, concentration, and mental strain were made in addition to measuring knowledge. Engagement modes and coping strategies were also studied. Parametric and nonparametric statistical analyses were carried out according to distribution of the data. The majority of the subjects reported that they had enjoyed the training, had found it to be suitable, and had learned something new, although several asked for more difficult and complex scenarios as well as a richer virtual environment. The mean values for knowledge dropped during the 6 months from 8.0/10 to 6.25/10 (P = .002). Self-efficacy increased from before to after each of the two training sessions, from 5.9/7 to 6.5/7 (P = .01) after the first and from 6.0/7 to 6.7/7 (P = .03) after the second. The mean perceived concentration value increased from 54.2/100 to 66.6/100 (P = .006), and in general the mental strain was found to be low to moderate (mean = 2.6/10). Using scenario-based virtual world team training with avatars to train medical students in multi-person CPR was feasible and showed promising results. Although we

  19. EXPLORING SERVICE QUALITY IMPACTS ON CUSTOMER SATISFACTION IN MILITARY MEDICAL CENTRES: MODERATING ROLE OF PERCEIVED VALUE

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2016-12-01

    Full Text Available Much has been written about service quality impacts on customer satisfaction. However, little research on this perspective has been carried out in military settings. The aim of this study is to examine the relationship between service quality and customer satisfaction, and moderating effects of perceived value in military medical centre. A survey method was employed and data was collected from customers at medical centers under the administration of Malaysian army organization. Analysis was performed using SmartPLS path model analysis. The results show two important findings: first, the interaction between four service quality components (i.e., tangible, reliability, responsiveness and assurance and customers’ perceived value were significantly correlated with customer satisfaction. Second, the interaction between one service quality component (i.e., tangible were not significantly correlated with customer satisfaction. In overall, this result confirms that effect of tangible, reliability, responsiveness and assurance on customer satisfaction has been moderated by customers’ perceived value. Conversely, effect empathy on customer satisfaction has not been moderated by customers’ perceived value. Further, this study offers discussion, implications and conclusion.

  20. Exploring DeepMedic for the purpose of segmenting white matter hyperintensity lesions

    Science.gov (United States)

    Lippert, Fiona; Cheng, Bastian; Golsari, Amir; Weiler, Florian; Gregori, Johannes; Thomalla, Götz; Klein, Jan

    2018-02-01

    DeepMedic, an open source software library based on a multi-channel multi-resolution 3D convolutional neural network, has recently been made publicly available for brain lesion segmentations. It has already been shown that segmentation tasks on MRI data of patients having traumatic brain injuries, brain tumors, and ischemic stroke lesions can be performed very well. In this paper we describe how it can efficiently be used for the purpose of detecting and segmenting white matter hyperintensity lesions. We examined if it can be applied to single-channel routine 2D FLAIR data. For evaluation, we annotated 197 datasets with different numbers and sizes of white matter hyperintensity lesions. Our experiments have shown that substantial results with respect to the segmentation quality can be achieved. Compared to the original parametrization of the DeepMedic neural network, the timings for training can be drastically reduced if adjusting corresponding training parameters, while at the same time the Dice coefficients remain nearly unchanged. This enables for performing a whole training process within a single day utilizing a NVIDIA GeForce GTX 580 graphics board which makes this library also very interesting for research purposes on low-end GPU hardware.

  1. Improved positive electrode materials for lithium-ion batteries: Exploring the high specific capacity of lithium cobalt dioxide and the high rate capability of lithium iron phosphate

    Science.gov (United States)

    Chen, Zhaohui

    During the past decade, the search for better electrode materials for Li-ion batteries has been of a great commercial interest, especially since Li-ion technology has become a major rechargeable battery technology with a market value of $3 billion US dollars per year. This thesis focuses on improving two positive electrode materials: one is a traditional positive electrode material--LiCoO2; the other is a new positive electrode material--LiFePO 4. Cho et al. reported that coating LiCoO2 with oxides can improve the capacity retention of LiCoO2 cycled to 4.4 V. The study of coatings in this thesis confirms this effect and shows that further improvement (30% higher energy density than that used in a commercial cell with excellent capacity retention) can be obtained. An in-situ XRD study proves that the mechanism of the improvement in capacity retention by coating proposed by Cho et al. is incorrect. Further experiments identify the suppression of impedance growth in the cell as the key reason for the improvement caused by coating. Based on this, other methods to improve the energy density of LiCoO2, without sacrificing capacity retention, are also developed. Using an XRD study, the structure of the phase between the O3-phase Li 1-xCoO2 (x > 0.5) and the O1 phase CoO2 was measured experimentally for the first time. XRD results confirmed the prediction of an H1-3 phase by Ceder's group. Apparently, because of the structural changes between the O3 phase and the H1-3 phase, good capacity retention cannot be attained for cycling LiCoO2 to 4.6 V with respect to Li metal. An effort was also made to reduce the carbon content in a LiFePO 4/C composite without sacrificing its rate capability. It was found that about 3% carbon by weight maintains both a good rate capability and a high pellet density for the composite.

  2. Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region.

    Science.gov (United States)

    Nyström, M E; Höög, E; Garvare, R; Andersson Bäck, M; Terris, D D; Hansson, J

    2018-05-24

    Eldercare and care of people with functional impairments is organized by the municipalities in Sweden. Improving care in these areas is complex, with multiple stakeholders and organizations. Appropriate strategies to develop capability for continuing organizational improvement and learning (COIL) are needed. The purpose of our study was to develop and pilot-test a flexible, multilevel approach for COIL capability building and to identify what it takes to achieve changes in key actors' approaches to COIL. The approach, named "Sustainable Improvement and Development through Strategic and Systematic Approaches" (SIDSSA), was applied through an action-research and action-learning intervention. The SIDSSA approach was tested in a regional research and development (R&D) unit, and in two municipalities handling care of the elderly and people with functional impairments. Our approach included a multilevel strategy, development loops of five flexible phases, and an action-learning loop. The approach was designed to support systems understanding, strategic focus, methodological practices, and change process knowledge - all of which required double-loop learning. Multiple qualitative methods, i.e., repeated interviews, process diaries, and documents, provided data for conventional content analyses. The new approach was successfully tested on all cases and adopted and sustained by the R&D unit. Participants reported new insights and skills. The development loop facilitated a sense of coherence and control during uncertainty, improved planning and problem analysis, enhanced mapping of context and conditions, and supported problem-solving at both the individual and unit levels. The systems-level view and structured approach helped participants to explain, motivate, and implement change initiatives, especially after working more systematically with mapping, analyses, and goal setting. An easily understood and generalizable model internalized by key organizational actors is an

  3. NASA Laboratory Analysis for Manned Exploration Missions

    Science.gov (United States)

    Krihak, Michael K.; Shaw, Tianna E.

    2014-01-01

    The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability Element under the NASA Human Research Program. ELA instrumentation is identified as an essential capability for future exploration missions to diagnose and treat evidence-based medical conditions. However, mission architecture limits the medical equipment, consumables, and procedures that will be available to treat medical conditions during human exploration missions. Allocated resources such as mass, power, volume, and crew time must be used efficiently to optimize the delivery of in-flight medical care. Although commercial instruments can provide the blood and urine based measurements required for exploration missions, these commercial-off-the-shelf devices are prohibitive for deployment in the space environment. The objective of the ELA project is to close the technology gap of current minimally invasive laboratory capabilities and analytical measurements in a manner that the mission architecture constraints impose on exploration missions. Besides micro gravity and radiation tolerances, other principal issues that generally fail to meet NASA requirements include excessive mass, volume, power and consumables, and nominal reagent shelf-life. Though manned exploration missions will not occur for nearly a decade, NASA has already taken strides towards meeting the development of ELA medical diagnostics by developing mission requirements and concepts of operations that are coupled with strategic investments and partnerships towards meeting these challenges. This paper focuses on the remote environment, its challenges, biomedical diagnostics requirements and candidate technologies that may lead to successful blood-urine chemistry and biomolecular measurements in future space exploration missions.

  4. The Need for Medical Geology in Space Exploration: Implications for the Journey to Mars and Beyond

    Science.gov (United States)

    Harrington, A. D.; Zeigler, R. A.; McCubbin, F. M.

    2018-01-01

    The previous manned missions to the Moon represent milestones in human ingenuity, perseverance, and intellectual curiosity. They also highlight a major hazard for future human exploration of the Moon and beyond: surface dust. Not only did the dust cause mechanical and structural integrity issues with the suits, the dust "storm" generated upon reentrance into the crew cabin caused "lunar hay fever" and "almost blindness". It was further reported that the allergic response to the dust worsened with each exposure. The lower gravity environment exacerbated the exposure, requiring the astronauts to wear their helmet within the module in order to avoid breathing the irritating particles. Due to the prevalence of these high exposures, the Human Research Roadmap developed by NASA identifies the Risk of Adverse Health and Performance Effects of Celestial Dust Exposure as an area of concern. Extended human exploration will further increase the probability of inadvertent and repeated exposures to celestial dusts. Going forward, hazard assessments of celestial dusts will be determined through sample return efforts prior to astronaut deployment. However, even then the returned samples could also put the Curators, technicians, and scientists at risk during processing and examination.

  5. Exploring the relationship between stress and acne: a medical student’s perspective

    Directory of Open Access Journals (Sweden)

    Maleki A

    2018-04-01

    Full Text Available Aryan Maleki, Noorulain Khalid Faculty of Medicine, Barts and The London School of Medicine and Dentistry, London, UKWe read with great interest the paper by Zari and Alrahmani1 investigating the relationship between stress and acne among female medical students. These findings are relevant as around 20% of young people are affected by moderate-to-severe acne, and indeed acne severity is associated with increased risks of anxiety, depression and suicidal ideation.2 The authors identified that “stress severity strongly correlated with an increase in acne severity,” and suggested that stress likely has an important role in the pathogenesis of acne.1 However, the paper could have been taken further to better establish the true extent of this relationship, and ultimately whether certain patients will benefit from clinical interventions based on their perceived stress scale. View the original paper by Zari and Alrahmani.

  6. Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

    Science.gov (United States)

    Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

    2017-09-01

    Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

  7. Exploring the effects of telehealth on medical human resources supply: a qualitative case study in remote regions

    Directory of Open Access Journals (Sweden)

    Duplantie Julie

    2007-01-01

    Full Text Available Abstract Background The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions. Methods A case study in Eastern Quebec was performed to explore this complex phenomenon. The analytical framework was based on two literature reviews and a Delphi study. Data were collected from semi-structured interviews with 41 physicians and 22 managers. Transcripts were produced and interview content was coded independently by two judges and validated by an expert panel. Results Interviews have highlighted the potential impact of telehealth on several factors influencing the recruitment and retention of physicians in rural and remote regions. The potential effects of telehealth on physicians' choice of practice location could be seen at the professional, organizational, educational and individual levels. For instance, telehealth could improve work satisfaction by allowing a regional on-call duty system and a better follow-up of patients. However, there are also certain limits related to telehealth, such as the fear that it would eventually replace all continuing medical education activities and onsite specialists in remoteregions. Conclusion Telehealth is likely to have an impact on several factors related to medical workforce supply in remote and rural regions. However, the expected benefits will materialize if and only if this technology is properly integrated into organizations as a support to professional practice.

  8. Exploring emerging learning needs: a UK-wide consultation on environmental sustainability learning objectives for medical education.

    Science.gov (United States)

    Walpole, Sarah C; Mortimer, Frances; Inman, Alice; Braithwaite, Isobel; Thompson, Trevor

    2015-12-24

    This study aimed to engage wide-ranging stakeholders and develop consensus learning objectives for undergraduate and postgraduate medical education. A UK-wide consultation garnered opinions of healthcare students, healthcare educators and other key stakeholders about environmental sustainability in medical education. The policy Delphi approach informed this study. Draft learning objectives were revised iteratively during three rounds of consultation: online questionnaire or telephone interview, face-to-face seminar and email consultation. Twelve draft learning objectives were developed based on review of relevant literature. In round one, 64 participants' median ratings of the learning objectives were 3.5 for relevance and 3.0 for feasibility on a Likert scale of one to four. Revisions were proposed, e.g. to highlight relevance to public health and professionalism. Thirty three participants attended round two. Conflicting opinions were explored. Added content areas included health benefits of sustainable behaviours. To enhance usability, restructuring provided three overarching learning objectives, each with subsidiary points. All participants from rounds one and two were contacted in round three, and no further edits were required. This is the first attempt to define consensus learning objectives for medical students about environmental sustainability. Allowing a wide range of stakeholders to comment on multiple iterations of the document stimulated their engagement with the issues raised and ownership of the resulting learning objectives.

  9. Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons.

    Science.gov (United States)

    Kidd, Monica; Nixon, Lara; Rosenal, Tom; Jackson, Roberta; Pereles, Laurie; Mitchell, Ian; Bendiak, Glenda; Hughes, Lisa

    2016-01-01

    Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students' observational skills, narrative skills, and empathy with their patients. Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice. We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient.

  10. Exploring the factors that influence physician technostress from using mobile electronic medical records.

    Science.gov (United States)

    Liu, Chung-Feng; Cheng, Tain-Junn; Chen, Chin-Tung

    2017-10-25

    This paper proposes an integrated model for investigating how physicians' perceived individual and technology characteristics affect their technological stress (technostress) that is derived from using mobile electronic medical records (MEMRs). Individual characteristics comprise constructs of mobile self-efficacy and technology dependence, whereas perceived technology characteristics comprise constructs of perceived usefulness, complexity, and reliability. We employed the survey method to collect 158 valid questionnaires from physicians working at three branch hospitals to determine perceptions regarding MEMRs, yielding a response rate of 33.62%. Partial least squares, a structural equation modeling technique, was used for model examination and hypothesis testing. The results show that physicians have a low perception of MEMR dependence and technostress. Furthermore, physicians' perceived MEMR technology dependency, mobile self-efficacy, and complexity were proven to significantly affect physician technostress when using MEMRs, whereas perceived usefulness and reliability were not. The explanatory power of the research model reached 67.8%. The results of this study provide valuable insights and significant knowledge for technostress in health care, particularly from academic and practical perspectives.

  11. Using visual art and collaborative reflection to explore medical attitudes toward vulnerable persons

    Directory of Open Access Journals (Sweden)

    Monica Kidd

    2016-04-01

    Full Text Available Background: Vulnerable persons often face stigma-related barriers while seeking health care. Innovative education and professional development methods are needed to help change this. Method: We describe an interdisciplinary group workshop designed around a discomfiting oil portrait, intended to trigger provocative conversations among health care students and practitioners, and we present our mixed methods analysis of participant reflections. Results: After the workshop, participants were significantly more likely to endorse the statements that the observation and interpretive skills involved in viewing visual art are relevant to patient care and that visual art should be used in medical education to improve students’ observational skills, narrative skills, and empathy with their patients.  Subsequent to the workshop, significantly more participants agreed that art interpretation should be required curriculum for health care students. Qualitative comments from two groups from two different education and professional contexts were examined for themes; conversations focused on issues of power, body image/self-esteem, and lessons for clinical practice.    Conclusions: We argue that difficult conversations about affective responses to vulnerable persons are possible in a collaborative context using well-chosen works of visual art that can stand in for a patient.

  12. Exploring the use of tablet PCs in veterinary medical education: opportunity or obstacle?

    Science.gov (United States)

    Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; van der Merwe, Deon

    2014-01-01

    A tablet PC is a laptop computer with a touch screen and a digital pen or stylus that can be used for handwritten notes and drawings. The use of tablet PCs has been investigated in many disciplines such as engineering, mathematics, science, and education. The purpose of this article is to explore student and faculty attitudes toward and experiences with tablet PCs 6 years after the implementation of a tablet PC program in the College of Veterinary Medicine (CVM) at Kansas State University (K-State). This study reports that the use of tablet PCs has enhanced students' learning experiences through learner-interface interaction, learner-content interaction, learner-instructor interaction, and learner-learner interaction. This study also identifies digital distraction as the major negative experience with tablet PCs during class time. The tablet PC program provides CVM faculty the potential to pursue technology integration strategies that support expected learning outcomes and provides students the potential to develop self-monitoring and self-discipline skills that support learning with digital technologies.

  13. Email communication at the medical primary–secondary care interface: a qualitative exploration

    Science.gov (United States)

    Sampson, Rod; Barbour, Rosaline; Wilson, Philip

    2016-01-01

    Background There is little published research into the influence of email communication between primary and secondary care clinicians on patient care. Aim To explore the use of email communication between clinicians across the primary– secondary care interface, and how this may relate to patient care. Design and setting A qualitative study involving primary and secondary care services in the NHS Highland Health Board area, Scotland. Ten GPs and 12 hospital consultants were purposively sampled to reflect diversity. Method Eligible clinicians were invited to take part in a semi-structured interview. Data were analysed using a thematic analysis approach. Results Key themes that emerged for clinicians included general perceptions of email; using email in practice (managing workload, impact on patient journeys, and ‘quick answers’); system issues (variability and governance); relational aspects; and email skills. Conclusion Email communication between primary and secondary care clinicians generally has a positive impact on patient access to specialist expertise. Governance issues around the use of clinical email need to be defined. There may currently be a two-tier health service for those patients (and their GPs) requiring ‘quick answers’. PMID:27162209

  14. Email communication at the medical primary-secondary care interface: a qualitative exploration.

    Science.gov (United States)

    Sampson, Rod; Barbour, Rosaline; Wilson, Philip

    2016-07-01

    There is little published research into the influence of email communication between primary and secondary care clinicians on patient care. To explore the use of email communication between clinicians across the primary- secondary care interface, and how this may relate to patient care. A qualitative study involving primary and secondary care services in the NHS Highland Health Board area, Scotland. Ten GPs and 12 hospital consultants were purposively sampled to reflect diversity. Eligible clinicians were invited to take part in a semi-structured interview. Data were analysed using a thematic analysis approach. Key themes that emerged for clinicians included general perceptions of email; using email in practice (managing workload, impact on patient journeys, and 'quick answers'); system issues (variability and governance); relational aspects; and email skills. Email communication between primary and secondary care clinicians generally has a positive impact on patient access to specialist expertise. Governance issues around the use of clinical email need to be defined. There may currently be a two-tier health service for those patients (and their GPs) requiring 'quick answers'. © British Journal of General Practice 2016.

  15. At the precipice: a prospective exploration of medical students' expectations of the pre-clerkship to clerkship transition.

    Science.gov (United States)

    Soo, Jason; Brett-MacLean, Pamela; Cave, Marie-Therese; Oswald, Anna

    2016-03-01

    Medical learners face many challenging transitions. We prospectively explored students' perceptions of their upcoming transition to clerkship and their future professional selves. In 2013, 160/165 end-of-second-year medical students wrote narrative reflections and 79/165 completed a questionnaire on their perceptions of their upcoming transition to clerkship. Narratives were separately analyzed by four authors and then discussed to identify a final thematic framework using parsimonious category construction. We identified two overarching themes: (1) "Looking back": experiences which had helped students feel prepared for clerkship with subthemes focused on of patient care, shadowing, classroom teaching and the pre-clerkship years as foundational knowledge, (2) "Looking forward": anticipating the clerkship experience and the journey of becoming a physician with subthemes focused on death and dying, hierarchy, work-life balance, interactions with patients, concerns about competency and career choice. Questionnaire data revealed incongruities around expectations of minimal exposure to death and dying, little need for independent study and limited direct patient responsibility. We confirmed that internal transformations are happening in contemplative time even before clerkship. By prospectively exploring pre-clerkship students' perceptions of the transition to clerkship training we identified expectations and misconceptions that could be addressed with future curricular interventions. While students are aware of and anticipating their learning needs it is not as clear that they realise how much their future learning will depend on their own inner resources. We suggest that more attention be paid to professional identity formation and the development of the physician as a person during these critical transitions.

  16. Exploration Laboratory Analysis FY13

    Science.gov (United States)

    Krihak, Michael; Perusek, Gail P.; Fung, Paul P.; Shaw, Tianna, L.

    2013-01-01

    The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk, which is stated as the Risk of Inability to Adequately Treat an Ill or Injured Crew Member, and ExMC Gap 4.05: Lack of minimally invasive in-flight laboratory capabilities with limited consumables required for diagnosing identified Exploration Medical Conditions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability in future exploration missions. Mission architecture poses constraints on equipment and procedures that will be available to treat evidence-based medical conditions according to the Space Medicine Exploration Medical Conditions List (SMEMCL), and to perform human research studies on the International Space Station (ISS) that are supported by the Human Health and Countermeasures (HHC) element. Since there are significant similarities in the research and medical operational requirements, ELA hardware development has emerged as a joint effort between ExMC and HHC. In 2012, four significant accomplishments were achieved towards the development of exploration laboratory analysis for medical diagnostics. These achievements included (i) the development of high priority analytes for research and medical operations, (ii) the development of Level 1 functional requirements and concept of operations documentation, (iii) the selection and head-to-head competition of in-flight laboratory analysis instrumentation, and (iv) the phase one completion of the Small Business Innovation Research (SBIR) projects under the topic Smart Phone Driven Blood-Based Diagnostics. To utilize resources efficiently, the associated documentation and advanced technologies were integrated into a single ELA plan that encompasses ExMC and HHC development efforts. The requirements and high priority analytes was used in the selection of the four in-flight laboratory analysis performers. Based upon the

  17. [Nursing workplace bullying and turnover intention: an exploration of associated factors at a medical center in Southern Taiwan].

    Science.gov (United States)

    Tsai, Shiau-Ting; Han, Chin-Hua; Chen, Li-Fang; Chou, Fan-Hao

    2014-06-01

    The chronic shortage of nursing staffs in hospitals continues to increasingly and negatively impact the ability of medical care systems to deliver effective care and ensure the safety of patients. Bullying is one factor known to exacerbate turnover in the nursing workplace. This study explores workplace bullying and turnover intention among nurses working at a medical center in Southern Taiwan. A cross-sectional and correlation research design was conducted using the Negative Acts Questionnaire-Revised (NAQ-R) and the Turnover Intention Questionnaire. A convenience, purposive sample of 708 nurses was recruited. Inclusion criteria included: holding an RN license, able to communicate in both Mandarin and Hokkienese, >6 months of clinical experience, and an NAQ-R score higher than 23. Data were analyzed using SPSS19.0 software. Approximately 85% of participants had experienced some degree of workplace bullying during the previous 6-month period. The trend of the turnover intention tended to the right at a high degree. A moderate, positive, and significant correlation was found between turnover intention and bullying total scores (r=.39, pturnover intention (15.10%). Based on our findings, we suggest that nurses should enhance their awareness of the negative consequences of workplace bullying. Furthermore, hospitals should implement appropriate mechanisms to decrease the phenomenon of inter-staff bullying, improve the nursing workplace environment, and reduce the rate of turnover intention.

  18. A dialogical exploration of the grey zone of health and illness: medical science, anthropology, and Plato on alcohol consumption.

    Science.gov (United States)

    Bonner, Kieran

    2009-01-01

    This paper takes a phenomenological hermeneutic orientation to explicate and explore the notion of the grey zone of health and illness and seeks to develop the concept through an examination of the case of alcohol consumption. The grey zone is an interpretive area referring to the irremediable zone of ambiguity that haunts even the most apparently resolute discourse. This idea points to an ontological indeterminacy, in the face of which decisions have to be made with regard to the health of a person (e.g., an alcoholic), a system (e.g., the health system), or a society. The fundamental character of this notion will be developed in relation to the discourse on health and the limitations of different disciplinary practices. The case of alcohol consumption will be used to tease out the grey zone embedded in the different kinds of knowledge made available through the disciplinary traditions of medical science, with its emphasis on somatic well-being, and anthropology, with its focus on communal well-being. This tension or grey zone embedded in different knowledge outcomes will be shown to have a discursive parallel with the dialogue between the Athenian, the Spartan, and the Cretan in Plato's Laws. Making use of the dialogical approach as described by Gadamer, the Athenian's particular resolution of the tension will be explored as a case study to demonstrate the necessarily particular analysis involved in a grey zone resolution.

  19. Virtual patient cases: to use or not to use? Exploring creators' attitudes against their use in the undergraduate medical curriculum

    Directory of Open Access Journals (Sweden)

    Areti Z. Karasmani

    2017-11-01

    Full Text Available Background: The problems and difficulties in students' education that arise from the existing undergraduate curriculum at the medical school of Aristotle University of Thessaloniki (AUTH urged the academic staff members to the pursuance of new pedagogic approaches that could revitalize medical education practice. The educational programs "mEducator", "ePBLnet" and "Ariadne" that run at AUTH laid the foundations for the development of a plenty of virtual patient (VP cases. A VP is an innovative computer simulation method that can motivate students to occupy themselves with their studies and perfect their skills. Unfortunately, despite the indisputable advantages of embedding VPs to the lessons, their utilization is neglected during the educational process at AUTH. Objective: The purpose of this study was to explore the reasons for which VP authors do not use their own VP cases. Why even VP authors avoid VPs' exploitation and in this way they forsake the insistent efforts they made through the rigorous process of VPs' creation? Methods: After study' s authorization, 35 academic staff members, who had previously developed their own VPs, signed an informed consent and fulfilled a specially designed questionnaire, mainly consisted of closed questions (answer: yes/no about the possible causes of VPs' dereliction. Results: Some 77% of participants granted that they do not utilize their own VP cases. Almost 56% of them admitted that the lack of proper infrastructures (computers, projectors and Internet connection in the lecture rooms impede VPs' use. Specifically, some 33% acknowledged the absence of access to the Internet as the only reason of VPs' abandonment. Almost 52% claimed that they do not have enough time in the courses for covering the great curriculum. Moreover, almost 30% sustained that the great number of students in the lessons enables all of them to conduct a fruitful discussion. Almost 15% asserted that they do not exploit VPs due to the

  20. Utilizing new GNSS capabilities for exploring Geospace

    Science.gov (United States)

    Coster, A. J.

    2015-12-01

    In 2000 the density of GPS receivers across the continental United States increased to the point that strictly data-driven regional maps of total electron content (TEC) could be constructed. These data-driven maps allowed the TEC to be monitored throughout the course of geomagnetic storms and to observe the progression of traveling ionospheric disturbances. This allowed studies of the development of storm enhanced density plumes in both hemispheres and of the dynamic changes in the equatorial TEC following stratospheric warming events. Currently, GPS TEC maps have become recognized as one of the premier tools to monitor coupling of atmospheric regions from both below and above the ionosphere. The number of available scientific dual-frequency receivers across the globe now exceeds 3000. However this number is anticipated to increase rapidly in part due to the numerous arrays being fielded for commercial applications such as precision farming and highway surveying. In addition, there will be a rapid increase in the number of GNSS signals available in the near future. Besides GPS, the European Union is building a system named GALILEO, which will consist of a 30-satellite constellation. The Russians have a system based on a 24-satellite constellation named GLONASS. The Chinese are developing a system called Beidou, which means "stars of the Big Dipper". The Beidou system will consist of 35 satellites. By 2023, there will be more than 160 GNSS satellites and 400 signals. Multi-constellation, multi-band GNSS will be a major enabler for space weather studies. This talk will focus on the potential of using the multiple new GNSS signals and the new higher density receiver arrays for measurements of plasma drift, detailed studies of traveling ionospheric disturbances (TIDS) and expanded studies of atmospheric coupling. We will conclude by describing the tremendous potential of merging GNSS observations with observations collected by arrays of low-cost, low-power, and small form factor ionosondes. In the future, we predict that new ionosonde and GNSS receiver networks will enable unprecedented mesoscale real-time tomographic observations of the ionosphere.

  1. Exploring the Role of Neuroticism and Insecure Attachment in Health Anxiety, Safety-Seeking Behavior Engagement, and Medical Services Utilization

    Directory of Open Access Journals (Sweden)

    Fotios Anagnostopoulos

    2016-06-01

    Full Text Available The purpose of this study was to explore an extended interpersonal model of health anxiety, according to which health-anxious individuals are trapped in a vicious circle of health-related reassurance-seeking, alienation from others, and worry about health, while somatic absorption with body sensations, insecure attachment, neuroticism, safety-seeking behaviors, and medical services utilization were also included in the model. Data were collected from 196 Greek university students using standardized instruments. Results indicated that anxious attachment was directly related to absorption (β = .163, p < .05 and alienation (β = .204, p < .05, while avoidant attachment was directly related to absorption (β = −.344, p < .001, reassurance-seeking (β = −.130, p < .05, and alienation (β = .148, p < .05. Neuroticism was positively and significantly associated with all dimensions of health anxiety. Absorption, alienation, and anxious attachment were related to medical services utilization, which, in turn, was related to safety-seeking behaviors (β = .200, p < .01. Neuroticism and anxious attachment were also indirectly and positively associated with worry. Moreover, absorption was positively related to worry and reassurance-seeking, worry was positively related to reassurance-seeking, and alienation was positively related to worry. Study results highlight the key role that interpersonal (e.g., alienation from others and perceptual factors (e.g., the tendency to focus on bodily sensations can play in health anxiety maintenance, and the importance of anxious and avoidant attachment in safety-seeking behavior engagement. Implications of the results and suggestions for future research and practice are outlined.

  2. Amartya Sen's Capability Approach and Education

    Science.gov (United States)

    Walker, Melanie

    2005-01-01

    The human capabilities approach developed by the economist Amartya Sen links development, quality of life and freedom. This article explores the key ideas in the capability approach of: capability, functioning, agency, human diversity and public participation in generating valued capabilities. It then considers how these ideas relate specifically…

  3. Stop. Think. Delirium! A quality improvement initiative to explore utilising a validated cognitive assessment tool in the acute inpatient medical setting to detect delirium and prompt early intervention.

    Science.gov (United States)

    Malik, Angela; Harlan, Todd; Cobb, Janice

    2016-11-01

    The paper examines the ability of nursing staff to detect delirium and apply early intervention to decrease adverse events associated with delirium. To characterise nursing practices associated with staff knowledge, delirium screening utilising the Modified Richmond Assessment Sedation Score (mRASS), and multicomponent interventions in an acute inpatient medical unit. Delirium incidence rates are up to 60% in frail elderly hospitalised patients. Under-recognition and inconsistent management of delirium is an international problem. Falls, restraints, and increased hospital length of stay are linked to delirium. A descriptive study. Exploration of relationships between cause and effect among cognitive screening, knowledge assessment and interventions. Success in identifying sufficient cases of delirium was not evident; however, multicomponent interventions were applied to patients with obvious symptoms. An increase in nursing knowledge was demonstrated after additional training. Delirium screening occurred in 49-61% of the target population monthly, with challenges in compliance and documentation of screening and interventions. Technological capabilities for trending mRASS results do not exist within the current computerised patient record system. Delirium screening increases awareness of nursing staff, prompting more emphasis on early intervention in apparent symptoms. Technological support is needed to effectively document and visualise trends in screening results. The study imparts future research on the effects of cognitive screening on delirium prevention and reduction in adverse patient outcomes. Evidence-based literature reveals negative patient outcomes associated with delirium. However, delirium is highly under-recognised indicating future research is needed to address nursing awareness and recognition of delirium. Additional education and knowledge transformation from research to nursing practice are paramount in the application of innovative strategies

  4. Medical Data Architecture (MDA) Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Gurram, M.; Wolfe, S.; Marker, N.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2018-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

  5. Exploring the Medical and Psychosocial Concerns of Adolescents and Young Adults With Craniofacial Microsomia: A Qualitative Study.

    Science.gov (United States)

    Hamilton, Kayla V; Ormond, Kelly E; Moscarello, Tia; Bruce, Janine S; Bereknyei Merrell, Sylvia; Chang, Kay W; Bernstein, Jonathan A

    2018-01-01

    This study explores the experiences of adolescents and young adults with craniofacial microsomia, including the impact of growing up with this craniofacial condition on daily life and sense of self. The results may guide future research on optimally supporting individuals with craniofacial microsomia during this critical life phase. Participants were recruited through a craniofacial center, online patient support groups, and social media sites. Eleven individual semistructured interviews with participants between 12 and 22 years old were conducted by a single interviewer, transcribed, iteratively coded, and thematically analyzed. Five themes were evident in the data: (1) impact on personal growth and character development, (2) negative psychosocial impact, (3) deciding to hide or reveal the condition, (4) desire to make personal surgical decisions, and (5) struggles with hearing loss. We identified both medical and psychosocial concerns prevalent among adolescents with craniofacial microsomia. Although adolescents with craniofacial microsomia exhibit considerable resilience, the challenges they face impact their sense of self and should be addressed through psychosocial support and counseling. Further research should investigate the potential benefit of the wider use of hearing aids, as well as the involvement of patients in decision-making about reconstructive ear surgery.

  6. Exploring perspectives on restraint during medical procedures in paediatric care: a qualitative interview study with nurses and physicians.

    Science.gov (United States)

    Svendsen, Edel Jannecke; Pedersen, Reidar; Moen, Anne; Bjørk, Ida Torunn

    2017-12-01

    The aim of this study was to explore nurses' and physicians' perspectives on and reasoning about the use of restraint during medical procedures on newly admitted preschoolers in somatic hospital care. We analysed qualitative data from individual interviews with a video recall session at the end with seven physicians and eight nurses. They had earlier participated in video recorded peripheral vein cannulations on preschool children. The data were collected between May 2012 and May 2013 at a paediatric hospital unit in Norway. The analysis resulted in three main themes: (1) disparate views on the concept of restraint and restraint use (2), ways to limit the use of physical restraint and its negative consequences, and (3) experience with the role of parents and their influence on restraint. Perspectives from both healthcare professions were represented in all the main themes and had many similarities. The results of this study may facilitate more informed and reflective discussions of restraint and contribute to higher awareness of restraint in clinical practice. Lack of guidance and scientific attention to restraint combined with conflicting interests and values among healthcare providers may result in insecurity, individual dogmatism, and a lack of shared discussions, language, and terminology.

  7. From anatomical 'competence' to complex capability. The views and experiences of UK tutors on how we should teach anatomy to medical students.

    Science.gov (United States)

    Regan de Bere, Sam; Mattick, Karen

    2010-10-01

    Developments in clinical education have recently challenged the identity of anatomy teaching and learning, leading to high profile debate over the potential implications for the competence levels of new doctors. However, the emphasis remains on methods of teaching, rather than a review of what well-rounded anatomical learning actually entails, and how teaching can address contemporary learning needs. This paper identifies and addresses some of these issues, drawing on expert views captured in qualitative research with anatomy tutors at twenty different medical schools in the UK. Three main themes emerging from our analysis are described: anatomy as a subject matter, the challenges of teaching or learning anatomy, and the use of teaching methods. We also detail how inductive analysis generated new hypotheses worthy of further consideration. These fall into two key categories: (1) improving anatomy curriculum design and (2) advancing anatomy education research.

  8. An ethnographic study exploring the role of ward-based Advanced Nurse Practitioners in an acute medical setting.

    Science.gov (United States)

    Williamson, Susan; Twelvetree, Timothy; Thompson, Jacqueline; Beaver, Kinta

    2012-07-01

    This article is a report of a study that aimed to examine the role of ward-based Advanced Nurse Practitioners and their impact on patient care and nursing practice. Revised doctor/nurse skill mix combined with a focus on improving quality of care while reducing costs has had an impact on healthcare delivery in the western world. Diverse advanced nursing practice roles have developed and their function has varied globally over the last decade. However, roles and expectations for ward-based Advanced Nurse Practitioners lack clarity, which may hinder effective contribution to practice. An ethnographic approach was used to explore the advanced nurse practitioner role. Participant observation and interviews of five ward-based Advanced Nurse Practitioners working in a large teaching hospital in the North West of England during 2009 were complemented by formal and informal interviews with staff and patients. Data were descriptive and broken down into themes, patterns and processes to enable interpretation and explanation. The overarching concept that ran through data analysis was that of Advanced Nurse Practitioners as a lynchpin, using their considerable expertise, networks and insider knowledge of health care not only to facilitate patient care but to develop a pivotal role facilitating nursing and medical practice. Sub-themes included enhancing communication and practice, acting as a role model, facilitating the patients' journey and pioneering the role. Ward-based Advanced Nurse Practitioners are pivotal and necessary for providing quality holistic patient care and their role can be defined as more than junior doctor substitutes. © 2012 Blackwell Publishing Ltd.

  9. Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.

    Science.gov (United States)

    Tan, Amy Cw; Emmerton, Lynne M; Hattingh, Laetitia; La Caze, Adam

    2015-01-01

    Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes. Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants

  10. Rights, goals, and capabilities

    NARCIS (Netherlands)

    van Hees, M.V.B.P.M

    This article analyses the relationship between rights and capabilities in order to get a better grasp of the kind of consequentialism that the capability theory represents. Capability rights have been defined as rights that have a capability as their object (rights to capabilities). Such a

  11. Coping with adverse drug events in patients with heart failure : Exploring the role of medication beliefs and perceptions

    NARCIS (Netherlands)

    De Smedt, R. H.; Jaarsma, T.; Ranchor, A. V.; van der Meer, K.; Groenier, K. H.; Haaijer-Ruskamp, F. M.; Denig, P.

    2012-01-01

    This study describes coping strategies that patients with heart failure (HF) use to manage adverse drug events (ADEs). The included coping strategies were social support seeking, information seeking, non-adherence and taking alleviating medication. The role of beliefs about medication and ADE

  12. Medical Data Architecture Project Status

    Science.gov (United States)

    Krihak, M.; Middour, C.; Lindsey, A.; Marker, N.; Wolfe, S.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

    2017-01-01

    The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and

  13. Exploration and Practice of Systematic Medical Ethics Education for Medical Students%医学生的医德系统教育探究与实践

    Institute of Scientific and Technical Information of China (English)

    李雅梅

    2011-01-01

    Medical ethics education for medical students should be progressively more systematic, which involves education on medical ethics cognition, emotion, will, and conduct. Based on the system of which cognition is the foundation, emotion the driving force, will the endurance, and conduct the utmost purpose, ethics education and teaching in theory and practice have been carried out systematically in the process of implementation, focusing on cultivating medical students' ethics cognition and emotion, training their ethics will and finally promoting the formation of their good ethical conducts.%在医德教育中,医德认知是基础,医德情感是动力、医德意志是保证、医德行为是目的.医学生的医德系统教育,应着力培育医学生的医德认知、培养医学生的医德情感、磨练医学生的医德意志,最终促使医学生养成医德行为.

  14. Proceedings of the annual conference of Association of Medical Physicists of India (Northern Chapter) - exploring diverse applications of medical physics in cancer management: souvenir and conference proceedings

    International Nuclear Information System (INIS)

    2016-01-01

    The scientific programme under this theme is designed in such a way that stimulates both scientific intellect and clinical knowledge in the field of Medical Physics in Radiation Oncology, Radiology, Nuclear Medicine and Radiation Protection. Papers relevant to INIS are indexed separately

  15. Benefits of Medical Home Care Reaching Beyond Chronically Ill Teens: Exploring Parent Health-Related Quality of Life.

    Science.gov (United States)

    Chavez, Laura J; Grannis, Connor; Dolce, Millie; Chisolm, Deena J

    2018-03-15

    Caring for teens with special health care needs places physical and mental health burdens on parents, which can be exacerbated by the stresses of transitions to independence. Medical homes can improve teen transitions to greater self-management and reduce health care-related time and financial burdens for families. We examined the association between parent-reported teen medical home status and caregiver health-related quality of life (HRQOL). The study sample included parents or caregivers of teens with special health care needs aged 15 to 18 recruited from a pediatric Medicaid accountable care organization who participated in a survey (response rate, 40.5%). The primary outcome was parent HRQOL scores (0-100 points) measured using the Pediatric Quality of Life Inventory Family Impact Module. Medical home status was based on parent report of teen's health care meeting medical home criteria. Linear regression models were used to estimate HRQOL scores, adjusted for demographic characteristics, health literacy, and teen functional limitation. Among 488 parents, 27% reported their teen received care consistent with a medical home. Adjusted parent HRQOL scores were significantly higher among those whose teens had a medical home (74.40; 95% confidence interval, 71.31-77.48), relative to those whose teens did not (65.78; 95% confidence interval, 63.92-67.65). Medical home subscale analyses showed HRQOL scores had significant positive associations with family-centered care and coordinated care, but not other subscales. Teen medical home status was positively associated with caregiver HRQOL, suggesting that the medical home may benefit overall caregiver well-being. In particular, receiving care that was family centered and coordinated appeared to be the most beneficial. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  16. Thank you for asking: Exploring patient perceptions of barcode medication administration identification practices in inpatient mental health settings.

    Science.gov (United States)

    Strudwick, Gillian; Clark, Carrie; McBride, Brittany; Sakal, Moshe; Kalia, Kamini

    2017-09-01

    Barcode medication administration systems have been implemented in a number of healthcare settings in an effort to decrease medication errors. To use the technology, nurses are required to login to an electronic health record, scan a medication and a form of patient identification to ensure that these correspond correctly with the ordered medications prior to medication administration. In acute care settings, patient wristbands have been traditionally used as a form of identification; however, past research has suggested that this method of identification may not be preferred in inpatient mental health settings. If barcode medication administration technology is to be effectively used in this context, healthcare organizations need to understand patient preferences with regards to identification methods. The purpose of this study was to elicit patient perceptions of barcode medication administration identification practices in inpatient mental health settings. Insights gathered can be used to determine patient-centered preferences of identifying patients using barcode medication administration technology. Using a qualitative descriptive approach, fifty-two (n=52) inpatient interviews were completed by a Peer Support Worker using a semi-structured interview guide over a period of two months. Interviews were conducted in a number of inpatient mental health areas including forensic, youth, geriatric, acute, and rehabilitation services. An interprofessional team, inclusive of a Peer Support Worker, completed a thematic analysis of the interview data. Six themes emerged as a result of the inductive data analysis. These included: management of information, privacy and security, stigma, relationships, safety and comfort, and negative associations with the technology. Patients also indicated that they would like a choice in the type of identification method used during barcode medication administration. As well, suggestions were made for how barcode medication

  17. Mobile Test Capabilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Electrical Power Mobile Test capabilities are utilized to conduct electrical power quality testing on aircraft and helicopters. This capability allows that the...

  18. [Exploring Flow and Supervision of Medical Instruments by Standing on Frontier of the Reform of Free Trade Zone].

    Science.gov (United States)

    Shen, Jianhua; Han, Meixian; Lu, Fei

    2017-11-30

    Shanghai Waigaoqiao Free Trade Zone as one of the special customs supervision areas of China (Shanghai) free trade pilot area, gathered a large number of general agent enterprises related to medical apparatus and instruments. This article analyzes the characteristics of special environment and medical equipment business in Shanghai Waigaoqiao Free Trade Zone in order to further implement the national administrative examination and approval reform. According to the latest requirement in laws and regulations of medical instruments, and trend of development in the industry of medical instruments, as well as research on the basis of practices of market supervision in countries around the world, this article also proposes measures about precision supervision, coordination of supervision, classification supervision and dynamic supervision to establish a new order of fair and standardized competition in market, and create conditions for establishment of allocation and transport hub of international medicine.

  19. Towards healthy learning climates in postgraduate medical education: exploring the role of hospital-wide education committees

    NARCIS (Netherlands)

    Silkens, Milou E. W. M.; Lombarts, Kiki M. J. M. H.; Scherpbier, Albert J. J. A.; Heineman, Maas Jan; Arah, Onyebuchi A.

    2017-01-01

    Background: Postgraduate medical education prepares residents for delivery of high quality patient care during training as well as for later practice, which makes high quality residency training programs crucial to safeguard patient care. Healthy learning climates contribute to high quality

  20. Dynamic capabilities and innovation capabilities: The case of the ‘Innovation Clinic’

    Directory of Open Access Journals (Sweden)

    Fred Strønen

    2017-01-01

    Full Text Available In this explorative study, we investigate the relationship between dynamic capabilities and innovation capabilities. Dynamic capabilities are at the core of strategic management in terms of how firms can ensure adaptation to changing environments over time. Our paper follows two paths of argumentation. First, we review and discuss some major contributions to the theories on ordinary capabilities, dynamic capabilities, and innovation capabilities. We seek to identify different understandings of the concepts in question, in order to clarify the distinctions and relationships between dynamic capabilities and innovation capabilities. Second, we present a case study of the ’Innovation Clinic’ at a major university hospital, including four innovation projects. We use this case study to explore and discuss how dynamic capabilities can be extended, as well as to what extent innovation capabilities can be said to be dynamic. In our conclusion, we discuss the conditions for nurturing ‘dynamic innovation capabilities’ in organizations.

  1. A balancing act: a phenomenological exploration of medical students' experiences of using mobile devices in the clinical setting.

    Science.gov (United States)

    Rashid-Doubell, F; Mohamed, S; Elmusharaf, K; O'Neill, C S

    2016-05-03

    The aims of this study were to describe the experiences of senior students using mobile devices in a clinical setting while learning and interacting with clinical teachers, patients and each other, and to identify challenges that facilitated or impeded the use of such devices in the hospital. Interpretative phenomenology was chosen to guide our enquiry. Semi-structured interviews were conducted to examine the experiences of five senior medical students using mobile devices in the clinical setting. Senior medical students at an international medical school in the Middle East. Three main themes emerged from the data analysis: learning; professional identity and transitioning from student to doctor. The findings showed that using mobile devices in the clinical area as a learning tool was not a formalised process. Rather, it was opportunistic learning at the bedside and on occasion a source of distraction from clinical teaching. Students needed to negotiate relationships between themselves, the clinical teacher and patients in order to ensure that they maintained an acceptable professional image. Participants experienced and negotiated the change from student to doctor making them mindful of using their devices at the bedside. Mobile devices are part of daily life for a medical student and there is a need to adapt medical education in the clinical setting, to allow the students to use their devices in a sensitive manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Exploring the usage of a mobile phone application in transplanted patients to encourage medication compliance and education.

    Science.gov (United States)

    Zanetti-Yabur, Alana; Rizzo, Amanda; Hayde, Nicole; Watkins, Anthony C; Rocca, Juan P; Graham, Jay A

    2017-10-01

    Medication non-adherence in transplant patients is a grave problem that results in increased rejection episodes, graft loss and significant morbidity. The efficacy of users and non-users of a mobile phone application (mobile app) in promoting medication adherence was investigated. The Beliefs about Medicine Questionnaire (BMQ) and Morisky Medication Adherence Scale (MMAS-8) were used in these cohorts to assess the predilection for poor adherence. Serum tacrolimus, creatinine levels, and rejection episodes were also recorded. Lastly, the patients were tested on their recall of their immunosuppression. Overall, patients had extremely negative beliefs about medication reflected in their tendency toward higher predicted rates of non-adherence. Interestingly, though not significant, app users had higher rates of medication recollection. The high-risk nature of this population demands efforts to abrogate non-adherence. Caregivers are charged with the responsibility to offer patients a feasible option to safeguard treatment compliance. Mobile apps are a potentially powerful tool, which can be used to decrease non-adherence. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. A pilot study exploring awareness among general public toward issues related to medication safety in the state of Penang, Malaysia

    Directory of Open Access Journals (Sweden)

    Mohamed Azmi Hassali

    2012-01-01

    Full Text Available Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistical analysis: Data were analyzed by using SPSS version 12.0 and descriptive statistics were reported where appropriate. Results: Majority of the respondents (n=292, 61.3% stated that they were well aware of the possible side effects of their current medications. A total of 196 respondents (41.17% believed that all medicines registered in Malaysia are safe to use as these medicines have no side effects. About 40.33% (n=192 of the respondents claimed that they share their unused medicines with family and friends who are having similar illness. Majority of respondents 57.7% (n=275 were satisfied with the drug information provided by the healthcare professionals. This study also found that more than 80% of the respondents (n=409 did report that they read the labels of their medication before using. Conclusions: In this study, it was revealed that there is a moderate level of public knowledge regarding medication safety. It is evident that public underestimates the risk of their medications. There is a general lack of awareness and understanding among the public especially toward side effects.

  4. A qualitative exploration of how Canadian informal caregivers in medical tourism use experiential resources to cope with providing transnational care.

    Science.gov (United States)

    Whitmore, Rebecca; Crooks, Valorie A; Snyder, Jeremy

    2017-01-01

    Canadians travelling abroad for privately arranged surgeries paid for out-of-pocket are engaging in what has come to be known as medical tourism. They are often accompanied by friends or family members, who we call caregiver-companions. Caregiver-companions provide care in and across a variety of formal and informal settings, such as in hotels, airplanes and at home. This qualitative study examines the experiences of informal caregivers in medical tourism to learn more about the lived experiences or 'experiential resources' they draw upon to cope with providing care and avoiding caregiver burden. The care-giving literature has demonstrated that such burden can negatively impact caregivers' well-being. The unique, transnational context of care-giving in medical tourism and recent growth in popularity of this practice means that there are few supports or resources currently in place to assist informal caregivers. In this article, we report on an analysis that sought to detail how caregiver-companions draw upon their previous lived experiences to cope with providing transnational care and to minimise or avoid the onset of caregiver burden. We conducted semi-structured telephone interviews with 20 Canadians who had accompanied their friends or family members abroad for surgery between September 2013 and January 2014. Thematic analysis revealed the ways that participants had developed practical strategies to deal with the challenges they faced in medical tourism. The interviews revealed three important experiential resources drawn upon by participants: (i) previous experiences of international travel; (ii) previous experiences of informal care-giving; and (iii) dimensions of the existing relationship with the care recipient. Differences in access to and use of these experiential resources related to participants' perspectives on medical tourism and the outcomes of the trip. By identifying the experiential resources drawn upon by informal caregivers in medical tourism

  5. Exploring medical undergraduates' perceptions of the educational value of a novel ENT iBook: a qualitative study.

    Science.gov (United States)

    Al-Hussaini, Ali; Tomkinson, Alun

    2016-01-01

    Undergraduate otolaryngology exposure is limited. It may be consolidated by the use of an iBook as a self-study tool. Following invitation to participate by email, five focus groups were formed, each consisting of six medical students (18 female, 12 male, median age 23 years). The focus group transcripts were imported to the qualitative data analysis software NVivo (QSR International, UK). The iBook was found to have a clear and consistent presentation, and a focused and user-friendly style, with reasonable interactivity and a good range of well-integrated media elements. It was, overall, perceived to be a valuable educational resource by the medical students.

  6. Dynamic capabilities, Marketing Capability and Organizational Performance

    Directory of Open Access Journals (Sweden)

    Adriana Roseli Wünsch Takahashi

    2017-01-01

    Full Text Available The goal of the study is to investigate the influence of dynamic capabilities on organizational performance and the role of marketing capabilities as a mediator in this relationship in the context of private HEIs in Brazil. As a research method we carried out a survey with 316 IES and data analysis was operationalized with the technique of structural equation modeling. The results indicate that the dynamic capabilities have influence on organizational performance only when mediated by marketing ability. The marketing capability has an important role in the survival, growth and renewal on educational services offerings for HEIs in private sector, and consequently in organizational performance. It is also demonstrated that mediated relationship is more intense for HEI with up to 3,000 students and other organizational profile variables such as amount of courses, the constitution, the type of institution and type of education do not significantly alter the results.

  7. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness

    NARCIS (Netherlands)

    Aschbrenner, K.A.; Pepin, R.; Mueser, K.T.; Naslund, J.A.; Rolin, S.A.; Faber, M.J.; Bartels, S.J.

    2014-01-01

    OBJECTIVE: Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received

  8. Quality management of medical specialist care in the Netherlands : an explorative study of its nature and development

    NARCIS (Netherlands)

    N.S. Klazinga (Niek)

    1996-01-01

    textabstractIn January 1985, the author of this study was employed as a scientific staff member at CBO, the Dutch National Organisation for Quality Assurance in Hospitals. His main job was to support peer review committees of medical specialists in hospitals. The task proved to be challenging and

  9. Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Lawton Gemma

    2005-03-01

    Full Text Available Abstract Background As assessment has been shown to direct learning, it is critical that the examinations developed to test clinical competence in medical undergraduates are valid and reliable. The use of extended matching questions (EMQ has been advocated to overcome some of the criticisms of using multiple-choice questions to test factual and applied knowledge. Methods We analysed the results from the Extended Matching Questions Examination taken by 4th year undergraduate medical students in the academic year 2001 to 2002. Rasch analysis was used to examine whether the set of questions used in the examination mapped on to a unidimensional scale, the degree of difficulty of questions within and between the various medical and surgical specialties and the pattern of responses within individual questions to assess the impact of the distractor options. Results Analysis of a subset of items and of the full examination demonstrated internal construct validity and the absence of bias on the majority of questions. Three main patterns of response selection were identified. Conclusion Modern psychometric methods based upon the work of Rasch provide a useful approach to the calibration and analysis of EMQ undergraduate medical assessments. The approach allows for a formal test of the unidimensionality of the questions and thus the validity of the summed score. Given the metric calibration which follows fit to the model, it also allows for the establishment of items banks to facilitate continuity and equity in exam standards.

  10. Mindfulness training for medical students in their clinical clerkships: two cross-sectional studies exploring interest and participation

    NARCIS (Netherlands)

    Dijk, I. van; Lucassen, P.L.B.J.; Speckens, A.E.M.

    2015-01-01

    BACKGROUND: So far, studies investigating Mindfulness Based Stress Reduction (MBSR) training in medical students are conducted in self-selected, pre-clinical samples, with modest response rates without collecting data on non-participants. This study first examines interest and participation rates of

  11. Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community: a mixed studies review.

    Science.gov (United States)

    Aston, Lydia; Hilton, Andrea; Moutela, Tiago; Shaw, Rachel; Maidment, Ian

    2017-10-18

    Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods). Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication. This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes.

  12. Judgmental Forecasting of Operational Capabilities

    DEFF Research Database (Denmark)

    Hallin, Carina Antonia; Tveterås, Sigbjørn; Andersen, Torben Juul

    This paper explores a new judgmental forecasting indicator, the Employee Sensed Operational Capabilities (ESOC). The purpose of the ESOC is to establish a practical prediction tool that can provide early signals about changes in financial performance by gauging frontline employees’ sensing...... of changes in the firm’s operational capabilities. We present the first stage of the development of ESOC by applying a formative measurement approach to test the index in relation to financial performance and against an organizational commitment scale. We use distributed lag models to test whether the ESOC...

  13. Exploring the use of smartphones and tablets by medical House Officers in Korle-Bu Teaching Hospital.

    Science.gov (United States)

    Barnor-Ahiaku, Edem

    2016-03-01

    Smartphones and tablets are being used widely in the Western World creating benefits in healthcare. The Ministry of Health in Ghana has an e-Health strategy, with the aim of integrating such resources into healthcare. Whilst there are numerous mHealth projects going on in Ghana, there is little evidence of doctors using such devices in their practice. A qualitative study was undertaken in Korle-Bu Teaching Hospital. Random sampling was used to identify House Officers, who engaged in semi-structured interviews. Interviews were recorded, transcribed and analysed using thematic content analysis. Consent was gained from all participants and the University of Leeds granted ethical approval. The results demonstrate that current House Officers began using smartphones and tablets at various stages during medical school. Their use has increased since qualification. Although the overall use has increased, some staff remain resistant to the use of smartphones and tablets. In the future, the integration of smartphones and tablets into medical practice can be improved by integration with the medical curriculum and accepted practice. House Officers are routinely using smartphones and tablets to assist them in their daily practice. The use is informal and is peer led. Whilst they bring many benefits, there are issues, which need to be addressed. In Korle-Bu Teaching Hospital integrating smartphone and tablet use into practice is feasible and would prove beneficial.

  14. Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer.

    Science.gov (United States)

    Mazerolle, Stephanie M; Eason, Christianne M; Goodman, Ashley

    2016-02-01

    Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided. To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer. Mixed-methods qualitative and quantitative study. The NCAA Division I. Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26-52 years), with 12 ± 7 years (range, 3-29 years) of athletic training experience. All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility. Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and opportunities for rejuvenation. For many, the summer season mimicked the hours, workload, and expectations of the nontraditional season

  15. Exploring Summer Medical Care Within the National Collegiate Athletic Association Division I Setting: A Perspective From the Athletic Trainer

    Science.gov (United States)

    Mazerolle, Stephanie M.; Eason, Christianne M.; Goodman, Ashley

    2016-01-01

    Context:  Over the last few decades, the National Collegiate Athletics Association (NCAA) has made changes related to the increase in sanctioned team activities during summer athletics. These changes may affect how athletic training services are provided. Objective:  To investigate the methods by which athletic training departments of NCAA institutions manage expectations regarding athletic training services during the summer. Design:  Mixed-methods qualitative and quantitative study. Setting:  The NCAA Division I. Patients or Other Participants:  Twenty-two athletic trainers (13 men, 9 women) participated. All were employed full time within the NCAA Division I setting. Participants were 35 ± 8 years of age (range, 26−52 years), with 12 ± 7 years (range, 3−29 years) of athletic training experience. Data Collection and Analysis:  All participants completed a series of questions online that consisted of closed- (demographic and Likert-scale 5-point) and open-ended items that addressed the research questions. Descriptive statistics, frequency distributions, and phenomenologic analyses were completed with the data. Peer review and multiple-analyst triangulation established credibility. Results:  Summer athletic training services included 3 primary mechanisms: individual medical care, shared medical care, or a combination of the 2. Participants reported working 40 ± 10 hours during the summer. Likert-item analysis showed that participants were moderately satisfied with their summer medical care structure (3.3 ± 1.0) and with the flexibility of summer schedules (3.0 ± 1.2). Yet the qualitative analysis revealed that perceptions of summer medical care were more positive for shared-care participants than for individual- or combination-care participants. The perceived effect on the athletic trainer included increased workload and expectations and a negative influence on work-life balance, particularly in terms of decreased schedule flexibility and

  16. Mollie Lentaigne, the nurse who drew McIndoe's Guinea pigs: Exploring the role of a medical artist at the Queen Victoria Hospital, 1940-1945.

    Science.gov (United States)

    Baldwin, Alexander J

    2018-04-16

    Mollie Lentaigne was a medical artist who worked at the Queen Victoria Hospital in East Grinstead during the Second World War alongside Archibald McIndoe and his dedicated team. She drew hundreds of medical illustrations for McIndoe and his fellow surgeons during the years between 1940 and 1945. Her illustrations depict the plastic surgery that was carried out in that hospital on the badly burnt RAF servicemen injured during the war that took place in the skies over Europe, which included many aircrew injured during the Battle of Britain. This project looks at the career of Lentaigne and her role within the surgical team in East Grinstead during that era and explores a number of Lentaigne's illustrations whilst providing context as to the procedures and patients depicted. An examination of Lentaigne's story, using an interview conducted by the author with the artist offers an alternative perspective with which to observe the events that unfolded in East Grinstead during that conflict. An analysis of these images shows the ability of this artist to portray relatively complex operations with a series of simple pencil or ink diagrams whilst also skilfully engaging the observer's sense of touch. The ability of a medical artist to be selective with her illustrations allowed them to provide clearer, less cluttered images that were preferred by McIndoe when recording the specific surgical procedures for use in the patient's medical records. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Exploring the beliefs underlying attitudes to active voluntary euthanasia in a sample of Australian medical practitioners and nurses: a qualitative analysis.

    Science.gov (United States)

    White, Katherine M; Wise, Susi E; Young, Ross McD; Hyde, Melissa K

    A qualitative study explored beliefs about active voluntary euthanasia (AVE) in a sample (N = 18) of medical practitioners and nurses from Australia, where AVE is not currently legal. Four behaviors relating to AVE emerged during the interviews: requesting euthanasia for oneself, legalizing AVE, administering AVE to patients if it were legalized, and discussing AVE with patients if they request it. Using thematic analysis, interviews were analyzed for beliefs related to advantages and disadvantages of performing these AVE behaviors. Medical practitioners and nurses identified a number of similar benefits for performing the AVE-related behaviors, both for themselves personally and as health professionals. Benefits also included a consideration of the positive impact for patients, their families, and the health care system. Disadvantages across behaviors focused on the potential conflict between those parties involved in the decision making process, as well as conflict between one's own personal and professional values.

  18. Evaluating the Effects of Medical Explorers a Case Study Curriculum on Critical Thinking, Attitude Toward Life Science, and Motivational Learning Strategies in Rural High School Students

    Science.gov (United States)

    Brand, Lance G.

    2011-12-01

    The purpose of this study was three-fold: to measure the ability of the Medical Explorers case-based curriculum to improve higher order thinking skills; to evaluate the impact of the Medical Explorers case-based curriculum to help students be self directed learners; and to investigate the impact of the Medical Explorers case-based curriculum to improve student attitudes of the life sciences. The target population for this study was secondary students enrolled in advanced life science programs. The resulting sample (n = 71) consisted of 36 students in the case-based experimental group and 35 students in the control group. Furthermore, this study employed an experimental, pretest-posttest control group research design. The treatment consisted of two instructional strategies: case-based learning and teacher-guided learning. Analysis of covariance indicated no treatment effect on critical thinking ability or Motivation and Self-regulation of Learning. However, the Medical Explorers case-based curriculum did show a treatment effect on student attitudes toward the life sciences. These results seem to indicate that case-based curriculum has a positive impact on students' perspectives and attitudes about the study of life science as well as their interest in life science based careers. Such outcomes are also a good indicator that students enjoy and perceive the value to use of case studies in science, and because they see value in the work that they do they open up their minds to true learning and integration. Of additional interest was the observationthat on average eleventh graders showed consistently stronger gains in critical thinking, motivation and self-regulation of learning strategies, and attitudes toward the life sciences as compared to twelfth grade students. In fact, twelfth grade students showed a pre to post loss on the Watson-Glaser and the MSLQ scores while eleventh grade students showed positive gains on each of these instruments. This decline in twelfth

  19. [Exploration of the design of media access control layer of wireless body area network for medical healthcare].

    Science.gov (United States)

    Liu, Xuemei; Ge, Baofeng

    2012-04-01

    This paper proposes a media access control (MAC) layer design for wireless body area network (WBAN) systems. WBAN is a technology that targets for wireless networking of wearable and implantable body sensors which monitor vital body signs, such as heart-rate, body temperature, blood pressure, etc. It has been receiving attentions from international organizations, e. g. the Institute of Electrical and Electronics Engineers (IEEE), due to its capability of providing efficient healthcare services and clinical management. This paper reviews the standardization procedure of WBAN and summarizes the challenge of the MAC layer design. It also discusses the methods of improving power consumption performance, which is one of the major issues of WBAN systems.

  20. Training reproductive health professionals in a post-conflict environment: exploring medical, nursing, and midwifery education in Mogadishu, Somalia.

    Science.gov (United States)

    Yalahow, Abdiasis; Hassan, Mariam; Foster, Angel M

    2017-11-01

    Following two decades of civil war, Somalia recently entered the post-conflict rebuilding phase that has resulted in the rapid proliferation of higher education institutions. Given the high maternal mortality ratio, the federal government has identified the reproductive health education of health service professionals as a priority. Yet little is known about the coverage of contraception, abortion, pregnancy, childbirth, and sexual and gender-based violence (SGBV) in medicine, nursing, or midwifery. In 2016, we conducted a multi-methods study to understand the reproductive health education and training landscape and identify avenues by which development of the next generation of health service professionals could be improved. Our study comprised two components: interviews with 20 key informants and 7 focus group discussions (FGDs) with 48 physicians, nurses, midwives, and medical students. Using the transcripts, memos, and field notes, we employed a multi-phased approach to analyse our data for content and themes. Our findings show that reproductive health education for medical and nursing students is inconsistent and significant content gaps, particularly in abortion and SGBV, exist. Students have few clinical training opportunities and the overarching challenges plaguing higher education in Somalia also impact health professions programmes in Mogadishu. There is currently a window of opportunity to develop creative strategies to improve the breadth and depth of evidence-based education and training, and multi-stakeholder engagement and the promotion of South-South exchanges appear warranted.

  1. Geospatial Information System Capability Maturity Models

    Science.gov (United States)

    2017-06-01

    To explore how State departments of transportation (DOTs) evaluate geospatial tool applications and services within their own agencies, particularly their experiences using capability maturity models (CMMs) such as the Urban and Regional Information ...

  2. Space Communications Capability Roadmap Interim Review

    Science.gov (United States)

    Spearing, Robert; Regan, Michael

    2005-01-01

    Contents include the following: Identify the need for a robust communications and navigation architecture for the success of exploration and science missions. Describe an approach for specifying architecture alternatives and analyzing them. Establish a top level architecture based on a network of networks. Identify key enabling technologies. Synthesize capability, architecture and technology into an initial capability roadmap.

  3. Networking capability and new product development

    NARCIS (Netherlands)

    Mu, J.; Di Benedetto, A.C.

    2012-01-01

    Current research on network theory remains largely focused on structures and outcomes without exploring the capability that firms need to build efficient and effective networks to their advantage. In this paper, we take a networking capability view in studying inter-firm relationships. We assume

  4. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    2015-01-01

    In this paper we study whether and how the interaction between clients and the service providers contributes to the development of capabilities in service provider firms. In situations where such a contribution occurs, we analyze how different types of activities in the production process...... process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....... of the services, such as sequential or reciprocal task activities, influence the development of different types of capabilities. We study five cases of offshore-outsourced knowledge-intensive business services that are distinguished according to their reciprocal or sequential task activities in their production...

  5. A multi-institutional study exploring the impact of positive mental health on medical students' professionalism in an era of high burnout.

    Science.gov (United States)

    Dyrbye, Liselotte N; Harper, William; Moutier, Christine; Durning, Steven J; Power, David V; Massie, F Stanford; Eacker, Anne; Thomas, Matthew R; Satele, Daniel; Sloan, Jeff A; Shanafelt, Tait D

    2012-08-01

    Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience. The authors surveyed 4,400 medical students at seven U.S. medical schools in 2009 to assess mental health (categorized as languishing, moderate, and flourishing) and burnout. Additional items explored professional behaviors, beliefs, suicidal ideation, and serious thoughts of dropping out. A total of 2,682/4,400 (61%) responded. Prevalence of suicidal ideation (55/114 [48.2%], 281/1,128 [24.9%], and 127/1,409 [9.1%]) and serious thoughts of dropping out (15/114 [13.2%], 30/1,128 [2.7%], and 14/1,409 [1.0%]) decreased as mental health improved from languishing, moderate, and flourishing, respectively (all P mental health persisted independent of burnout (all P mental health improved, the prevalence of unprofessional behaviors (i.e., cheating and dishonest behaviors) also declined, whereas students' altruistic beliefs regarding physicians' responsibility toward society improved. For example, 33/113 (29.2%), 426/1,120 (38.0%), and 718/1,391 (51.6%) of students with languishing, moderate, and flourishing mental health endorsed all five altruistic professional beliefs (P mental health persisted among students with burnout, whereas fewer relationships were found among students without burnout. Findings suggest that positive mental health attenuates some adverse consequences of burnout. Medical student wellness programs should aspire to prevent burnout and promote mental health.

  6. Giving Voice to the Medically Under-Served: A Qualitative Co-Production Approach to Explore Patient Medicine Experiences and Improve Services to Marginalized Communities.

    Science.gov (United States)

    Latif, Asam; Tariq, Sana; Abbasi, Nasa; Mandane, Baguiasri

    2018-01-27

    With an aging population, the appropriate, effective and safe use of medicines is a global health priority. However, "'medically under-served" patients continue to experience significant inequalities around access to healthcare services. This study forms part of a wider project to co-develop and evaluate a digital educational intervention for community pharmacy. The aim of this paper is to explore the medicine needs of patients from marginalized communities and suggest practical way on how services could be better tailored to their requirements. Following ethical approval, qualitative data was gathered from: (1) workshops with patients and professionals ( n = 57 attendees); and (2) qualitative semi-structured interviews (10 patients and 10 pharmacists). Our findings revealed that patients from marginalized communities reported poor management of their medical conditions and significant problems with adherence to prescribed medicines. Their experience of pharmacy services was found to be variable with many experiencing discrimination or disadvantage as a result of their status. This study highlights the plight of medically under-served communities and the need for policy makers to tailor services to an individual's needs and circumstances. Furthermore, patients and professionals can work in collaboration using a co-production approach to develop educational interventions for pharmacy service improvements.

  7. Prevalence of Depression in Medical Students at the Lebanese University and Exploring its Correlation With Facebook Relevance: A Questionnaire Study.

    Science.gov (United States)

    Naja, Wadih J; Kansoun, Alaa H; Haddad, Ramzi S

    2016-05-31

    The prevalence of major depression is particularly high in medical students, affecting around one-third of this population. Moreover, online social media, in particular Facebook, is becoming an intrinsic part in the life of a growing proportion of individuals worldwide. Our primary objective is to identify the prevalence of depression in medical students at the Lebanese University Faculty of Medicine, a unique state university in Lebanon, its correlation with the utilization of the interactive features of Facebook, and the way students may resort to these features. Students of the Lebanese University Faculty of Medicine were assessed for (1) depression and (2) Facebook activity. To screen for major depression, we used the Patient Health Questionnaire-9 (PHQ-9) scale. To test for Facebook activity, we developed the Facebook Resorting Questionnaire (FbRQ), which measures the degree to which students resort to Facebook. A total of 365 out of 480 students (76.0%) participated in the survey. A total of 25 students were excluded, hence 340 students were included in the final analysis. Current depression was reported in 117 students out of 340 (34.4%) and t tests showed female predominance. Moreover, PHQ-9 score multiple regression analysis showed that feeling depressed is explained 63.5% of the time by specific independent variables studied from the PHQ-9 and the FbRQ. Depression varied significantly among the different academic years (PFacebook had a positive and significant relationship (P=.003) and the different FbRQ categories had significant differences in resorting-to-Facebook power. The like, add friend, and check-in features students used when resorting to Facebook were significantly associated with depression. This study showed that depression was highly prevalent among students of the Faculty of Medicine at the Lebanese University. Moreover, Facebook may be a promising, helpful, psychological tool for optimizing the management of depression. Our study brought

  8. Capability Handbook- offline metrology

    DEFF Research Database (Denmark)

    Islam, Aminul; Marhöfer, David Maximilian; Tosello, Guido

    This offline metrological capability handbook has been made in relation to HiMicro Task 3.3. The purpose of this document is to assess the metrological capability of the HiMicro partners and to gather the information of all available metrological instruments in the one single document. It provides...

  9. Dynamic Capabilities and Performance

    DEFF Research Database (Denmark)

    Wilden, Ralf; Gudergan, Siegfried P.; Nielsen, Bo Bernhard

    2013-01-01

    are contingent on the competitive intensity faced by firms. Our findings demonstrate the performance effects of internal alignment between organizational structure and dynamic capabilities, as well as the external fit of dynamic capabilities with competitive intensity. We outline the advantages of PLS...

  10. Developing Alliance Capabilities

    DEFF Research Database (Denmark)

    Heimeriks, Koen H.; Duysters, Geert; Vanhaverbeke, Wim

    This paper assesses the differential performance effects of learning mechanisms on the development of alliance capabilities. Prior research has suggested that different capability levels could be identified in which specific intra-firm learning mechanisms are used to enhance a firm's alliance...

  11. Telematics Options and Capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Hodge, Cabell [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-05

    This presentation describes the data tracking and analytical capabilities of telematics devices. Federal fleet managers can use the systems to keep their drivers safe, maintain a fuel efficient fleet, ease their reporting burden, and save money. The presentation includes an example of how much these capabilities can save fleets.

  12. Medical Optimization Network for Space Telemedicine Resources

    Science.gov (United States)

    Shah, R. V.; Mulcahy, R.; Rubin, D.; Antonsen, E. L.; Kerstman, E. L.; Reyes, D.

    2017-01-01

    INTRODUCTION: Long-duration missions beyond low Earth orbit introduce new constraints to the space medical system such as the inability to evacuate to Earth, communication delays, and limitations in clinical skillsets. NASA recognizes the need to improve capabilities for autonomous care on such missions. As the medical system is developed, it is important to have an ability to evaluate the trade space of what resources will be most important. The Medical Optimization Network for Space Telemedicine Resources was developed for this reason, and is now a system to gauge the relative importance of medical resources in addressing medical conditions. METHODS: A list of medical conditions of potential concern for an exploration mission was referenced from the Integrated Medical Model, a probabilistic model designed to quantify in-flight medical risk. The diagnostic and treatment modalities required to address best and worst-case scenarios of each medical condition, at the terrestrial standard of care, were entered into a database. This list included tangible assets (e.g. medications) and intangible assets (e.g. clinical skills to perform a procedure). A team of physicians working within the Exploration Medical Capability Element of NASA's Human Research Program ranked each of the items listed according to its criticality. Data was then obtained from the IMM for the probability of occurrence of the medical conditions, including a breakdown of best case and worst case, during a Mars reference mission. The probability of occurrence information and criticality for each resource were taken into account during analytics performed using Tableau software. RESULTS: A database and weighting system to evaluate all the diagnostic and treatment modalities was created by combining the probability of condition occurrence data with the criticalities assigned by the physician team. DISCUSSION: Exploration Medical Capabilities research at NASA is focused on providing a medical system to

  13. Developing Acquisition IS Integration Capabilities

    DEFF Research Database (Denmark)

    Wynne, Peter J.

    2016-01-01

    An under researched, yet critical challenge of Mergers and Acquisitions (M&A), is what to do with the two organisations’ information systems (IS) post-acquisition. Commonly referred to as acquisition IS integration, existing theory suggests that to integrate the information systems successfully......, an acquiring company must leverage two high level capabilities: diagnosis and integration execution. Through a case study, this paper identifies how a novice acquirer develops these capabilities in anticipation of an acquisition by examining its use of learning processes. The study finds the novice acquirer...... applies trial and error, experimental, and vicarious learning processes, while actively avoiding improvisational learning. The results of the study contribute to the acquisition IS integration literature specifically by exploring it from a new perspective: the learning processes used by novice acquirers...

  14. FMEF/experimental capabilities

    International Nuclear Information System (INIS)

    Burgess, C.A.; Dronen, V.R.

    1981-01-01

    The Fuels and Materials Examination Facility (FMEF), under construction at the Hanford site north of Richland, Washington, will be one of the most modern facilities offering irradiated fuels and materials examination capabilities and fuel fabrication development technologies. Scheduled for completion in 1984, the FMEF will provide examination capability for fuel assemblies, fuel pins and test pins irradiated in the FFTF. Various functions of the FMEF are described, with emphasis on experimental data-gathering capabilities in the facility's Nondestructive and Destructive examination cell complex

  15. KSC Technical Capabilities Website

    Science.gov (United States)

    Nufer, Brian; Bursian, Henry; Brown, Laurette L.

    2010-01-01

    This document is the website pages that review the technical capabilities that the Kennedy Space Center (KSC) has for partnership opportunities. The purpose of this information is to make prospective customers aware of the capabilities and provide an opportunity to form relationships with the experts at KSC. The technical capabilities fall into these areas: (1) Ground Operations and Processing Services, (2) Design and Analysis Solutions, (3) Command and Control Systems / Services, (4) Materials and Processes, (5) Research and Technology Development and (6) Laboratories, Shops and Test Facilities.

  16. Resources, constraints and capabilities

    NARCIS (Netherlands)

    Dhondt, S.; Oeij, P.R.A.; Schröder, A.

    2018-01-01

    Human and financial resources as well as organisational capabilities are needed to overcome the manifold constraints social innovators are facing. To unlock the potential of social innovation for the whole society new (social) innovation friendly environments and new governance structures

  17. a Capability approach

    African Journals Online (AJOL)

    efforts towards gender equality in education as a means of achieving social justice. ... should mean that a lot of capability approach-oriented commentators are ... processes, their forms of exercising power, and their rules, unwritten cultures, ...

  18. Engineering Capabilities and Partnerships

    Science.gov (United States)

    Poulos, Steve

    2010-01-01

    This slide presentation reviews the engineering capabilities at Johnson Space Center, The presentation also reviews the partnerships that have resulted in successfully designed and developed projects that involved commercial and educational institutions.

  19. Dynamic capabilities and network benefits

    Directory of Open Access Journals (Sweden)

    Helge Svare

    2017-01-01

    Full Text Available The number of publicly funded initiatives to establish or strengthen networks and clusters, in order to enhance innovation, has been increasing. Returns on such investments vary, and the aim of this study is to explore to what extent the variation in benefits for firms participating in networks or clusters can be explained by their dynamic capabilities (DC. Based on survey data from five Norwegian networks, the results suggest that firms with higher DC are more successful in harvesting the potential benefits of being member of a network.

  20. Brandishing Cyberattack Capabilities

    Science.gov (United States)

    2013-01-01

    Advertising cyberwar capabilities may be helpful. It may back up a deterrence strategy. It might dissuade other states from conventional mischief or...to enable the attack.5 Many of the instruments of the attack remain with the target system, nestled in its log files, or even in the malware itself...debat- able. Even if demonstrated, what worked yesterday may not work today. But difficult does not mean impossible. Advertising cyberwar capabilities

  1. Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.

    Science.gov (United States)

    Herber, Oliver Rudolf; Gies, Verena; Schwappach, David; Thürmann, Petra; Wilm, Stefan

    2014-10-02

    The purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients' reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany. We conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework. Three interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions. Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.

  2. 'A band of brothers'-an exploration of the range of medical ethical issues faced by British senior military clinicians on deployment to Afghanistan: a qualitative study.

    Science.gov (United States)

    Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C

    2017-06-01

    To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Space Logistics: Launch Capabilities

    Science.gov (United States)

    Furnas, Randall B.

    1989-01-01

    The current maximum launch capability for the United States are shown. The predicted Earth-to-orbit requirements for the United States are presented. Contrasting the two indicates the strong National need for a major increase in Earth-to-orbit lift capability. Approximate weights for planned payloads are shown. NASA is studying the following options to meet the need for a new heavy-lift capability by mid to late 1990's: (1) Shuttle-C for near term (include growth versions); and (2) the Advanced Lauching System (ALS) for the long term. The current baseline two-engine Shuttle-C has a 15 x 82 ft payload bay and an expected lift capability of 82,000 lb to Low Earth Orbit. Several options are being considered which have expanded diameter payload bays. A three-engine Shuttle-C with an expected lift of 145,000 lb to LEO is being evaluated as well. The Advanced Launch System (ALS) is a potential joint development between the Air Force and NASA. This program is focused toward long-term launch requirements, specifically beyond the year 2000. The basic approach is to develop a family of vehicles with the same high reliability as the Shuttle system, yet offering a much greater lift capability at a greatly reduced cost (per pound of payload). The ALS unmanned family of vehicles will provide a low end lift capability equivalent to Titan IV, and a high end lift capability greater than the Soviet Energia if requirements for such a high-end vehicle are defined.In conclusion, the planning of the next generation space telescope should not be constrained to the current launch vehicles. New vehicle designs will be driven by the needs of anticipated heavy users.

  4. Campus Capability Plan

    Energy Technology Data Exchange (ETDEWEB)

    Adams, C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Arsenlis, T. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bailey, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bergman, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Brase, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Brenner, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Camara, L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Carlton, H. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Cheng, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Chrzanowski, P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Colson, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); East, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Farrell, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ferranti, L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gursahani, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hansen, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Helms, L. L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hernandez, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Jeffries, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Larson, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Lu, K. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); McNabb, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mercer, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Skeate, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sueksdorf, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Zucca, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Le, D. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ancria, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Scott, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Leininger, L. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gagliardi, F. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gash, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Bronson, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Chung, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hobson, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Meeker, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sanchez, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Zagar, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Quivey, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sommer, S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Atherton, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-06-06

    Lawrence Livermore National Laboratory Campus Capability Plan for 2018-2028. Lawrence Livermore National Laboratory (LLNL) is one of three national laboratories that are part of the National Nuclear Security Administration. LLNL provides critical expertise to strengthen U.S. security through development and application of world-class science and technology that: Ensures the safety, reliability, and performance of the U.S. nuclear weapons stockpile; Promotes international nuclear safety and nonproliferation; Reduces global danger from weapons of mass destruction; Supports U.S. leadership in science and technology. Essential to the execution and continued advancement of these mission areas are responsive infrastructure capabilities. This report showcases each LLNL capability area and describes the mission, science, and technology efforts enabled by LLNL infrastructure, as well as future infrastructure plans.

  5. Technological Capability's Predictor Variables

    Directory of Open Access Journals (Sweden)

    Fernanda Maciel Reichert

    2011-03-01

    Full Text Available The aim of this study was to identify the factors that influence in configuration of the technological capability of companies in sectors with medium-low technological intensity. To achieve the goal proposed in this article a survey was carried out. Based on the framework developed by Lall (1992 which classifies firms in basic, intermediate and advanced level of technological capability; it was found that the predominant technological capability is intermediate, with 83.7% of respondent companies (plastics companies in Brazil. It is believed that the main contribution of this study is the finding that the dependent variable named “Technological Capability” can be explained at a rate of 65% by six variables: development of new processes; selection of the best equipment supplier; sales of internally developed new technology to third parties; design and manufacture of equipment; study of the work methods and perform inventory control; and improvement of product quality.

  6. Capabilities for innovation

    DEFF Research Database (Denmark)

    Nielsen, Peter; Nielsen, Rene Nesgaard; Bamberger, Simon Grandjean

    2012-01-01

    is a survey that collected information from 601 firms belonging to the private urban sector in Denmark. The survey was carried out in late 2010. Keywords: dynamic capabilities/innovation/globalization/employee/employer cooperation/Nordic model Acknowledgment: The GOPA study was financed by grant 20080053113......Technological developments combined with increasing levels of competition related to the ongoing globalization imply that firms find themselves in dynamic, changing environments that call for dynamic capabilities. This challenges the internal human and organizational resources of firms in general...

  7. Human push capability.

    Science.gov (United States)

    Barnett, Ralph L; Liber, Theodore

    2006-02-22

    Use of unassisted human push capability arises from time to time in the areas of crowd and animal control, the security of locked doors, the integrity of railings, the removal of tree stumps and entrenched vehicles, the manoeuvering of furniture, and athletic pursuits such as US football or wrestling. Depending on the scenario, human push capability involves strength, weight, weight distribution, push angle, footwear/floor friction, and the friction between the upper body and the pushed object. Simple models are used to establish the relationships among these factors.

  8. The Capability Approach

    OpenAIRE

    Robeyns, Ingrid

    2011-01-01

    textabstract In its most general description, the capability approach is a flexible and multi-purpose normative framework, rather than a precise theory of well-being, freedom or justice. At its core are two normative claims: first, the claim that the freedom to achieve well-being is of primary moral importance, and second, that freedom to achieve well-being is to be understood in terms of people’s capabilities, that is, their real opportunities to do and be what they have reason to value. Thi...

  9. Sandia QIS Capabilities.

    Energy Technology Data Exchange (ETDEWEB)

    Muller, Richard P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-07-01

    Sandia National Laboratories has developed a broad set of capabilities in quantum information science (QIS), including elements of quantum computing, quantum communications, and quantum sensing. The Sandia QIS program is built atop unique DOE investments at the laboratories, including the MESA microelectronics fabrication facility, the Center for Integrated Nanotechnologies (CINT) facilities (joint with LANL), the Ion Beam Laboratory, and ASC High Performance Computing (HPC) facilities. Sandia has invested $75 M of LDRD funding over 12 years to develop unique, differentiating capabilities that leverage these DOE infrastructure investments.

  10. Enhancing radiation biodosimetry capability

    International Nuclear Information System (INIS)

    Alok, A.; Kumar, A.; Kulshrestra, S.; Choudhary, S.; Bhagi, S.; Adhikari, J.S.; Chaudhury, N.K.

    2016-01-01

    Biodosimetry laboratories are necessary for quick and accurate assessment of absorbed radiation dose in suspected individuals for their medical management. The method is based on dicentric chromosomal assay (Gold standard). This assay is completely manual and time consuming, require skill and competency of laboratory staff. There is a necessity of more biodosimetry labs within country and networking within and at international level for enhancing medical preparedness for management of radiation emergency

  11. [Nurse practitioner's capability].

    Science.gov (United States)

    Cheng, Chen-Hsiu; Chen, Shih-Chien

    2007-10-01

    Nurse practitioner development affirms the social value of nursing staff and promotes the professional image of nursing. As the medical environment and doctor-patient relations change, how should a nurse practitioner carry out clinical care? Apart from having foundations in medical knowledge and high-quality nursing techniques, nurse practitioners must have other clinical skills, in order to break out of their former difficult position, promote nursing competitiveness, provide a multi -dimensional service, win the people's acclamation and develop international links.

  12. ISOPHOT - Capabilities and performance

    DEFF Research Database (Denmark)

    Lemke, D.; Klaas, U.; Abolins, J.

    1996-01-01

    ISOPHOT covers the largest wavelength range on ISO from 2.5 to 240 mu m. Its scientific capabilities include multi filter and multi-aperture photometry, polarimetry, imaging and spectrophotometry. All modes can optionally include a focal plane chopper. The backbone of the photometric calibration...

  13. Capabilities and Special Needs

    DEFF Research Database (Denmark)

    Kjeldsen, Christian Christrup

    into international consideration in relation to the implementation of the UN convention on the rights of persons with disabilities. As for the theoretical basis, the research makes use of the sociological open-ended and relational concepts of Pierre Bourdieu and the normative yardstick of the Capability Approach...

  14. Metrology Measurement Capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Glen E. Gronniger

    2007-10-02

    This document contains descriptions of Federal Manufacturing & Technologies (FM&T) Metrology capabilities, traceability flow charts, and the measurement uncertainty of each measurement capability. Metrology provides NIST traceable precision measurements or equipment calibration for a wide variety of parameters, ranges, and state-of-the-art uncertainties. Metrology laboratories conform to the requirements of the Department of Energy Development and Production Manual Chapter 13.2, ANSI/ISO/IEC ANSI/ISO/IEC 17025:2005, and ANSI/NCSL Z540-1. FM&T Metrology laboratories are accredited by NVLAP for the parameters, ranges, and uncertainties listed in the specific scope of accreditation under NVLAP Lab code 200108-0. See the Internet at http://ts.nist.gov/Standards/scopes/2001080.pdf. These parameters are summarized. The Honeywell Federal Manufacturing & Technologies (FM&T) Metrology Department has developed measurement technology and calibration capability in four major fields of measurement: (1) Mechanical; (2) Environmental, Gas, Liquid; (3) Electrical (DC, AC, RF/Microwave); and (4) Optical and Radiation. Metrology Engineering provides the expertise to develop measurement capabilities for virtually any type of measurement in the fields listed above. A strong audit function has been developed to provide a means to evaluate the calibration programs of our suppliers and internal calibration organizations. Evaluation includes measurement audits and technical surveys.

  15. The Capability Approach

    NARCIS (Netherlands)

    I.A.M. Robeyns (Ingrid)

    2011-01-01

    textabstract In its most general description, the capability approach is a flexible and multi-purpose normative framework, rather than a precise theory of well-being, freedom or justice. At its core are two normative claims: first, the claim that the freedom to achieve well-being is of primary

  16. Sensor Alerting Capability

    Science.gov (United States)

    Henriksson, Jakob; Bermudez, Luis; Satapathy, Goutam

    2013-04-01

    There is a large amount of sensor data generated today by various sensors, from in-situ buoys to mobile underwater gliders. Providing sensor data to the users through standardized services, language and data model is the promise of OGC's Sensor Web Enablement (SWE) initiative. As the amount of data grows it is becoming difficult for data providers, planners and managers to ensure reliability of data and services and to monitor critical data changes. Intelligent Automation Inc. (IAI) is developing a net-centric alerting capability to address these issues. The capability is built on Sensor Observation Services (SOSs), which is used to collect and monitor sensor data. The alerts can be configured at the service level and at the sensor data level. For example it can alert for irregular data delivery events or a geo-temporal statistic of sensor data crossing a preset threshold. The capability provides multiple delivery mechanisms and protocols, including traditional techniques such as email and RSS. With this capability decision makers can monitor their assets and data streams, correct failures or be alerted about a coming phenomena.

  17. Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

    Directory of Open Access Journals (Sweden)

    Jih-Shuin Jerng

    Full Text Available There have been concerns about the workplace interpersonal conflict (WIC among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs.We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship and the three properties (disagreement, interference, and negative emotion, and analyzed relevant data.Of the 147 incidents with WIC, the most common related processes were patient transfer (20%, laboratory tests (17%, surgery (16% and medical imaging (16%. All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9% also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57% were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%, and the majority (67% of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064. The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1% than not on it (17.0%. The distributions of worker job types were similar between those with and without negative emotion (p = 0.125.The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

  18. Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center.

    Science.gov (United States)

    Jerng, Jih-Shuin; Huang, Szu-Fen; Liang, Huey-Wen; Chen, Li-Chin; Lin, Chia-Kuei; Huang, Hsiao-Fang; Hsieh, Ming-Yuan; Sun, Jui-Sheng

    2017-01-01

    There have been concerns about the workplace interpersonal conflict (WIC) among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS) widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs. We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship) and the three properties (disagreement, interference, and negative emotion), and analyzed relevant data. Of the 147 incidents with WIC, the most common related processes were patient transfer (20%), laboratory tests (17%), surgery (16%) and medical imaging (16%). All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9%) also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57%) were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%), and the majority (67%) of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064). The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1%) than not on it (17.0%). The distributions of worker job types were similar between those with and without negative emotion (p = 0.125). The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts.

  19. Capitalizing on capabilities.

    Science.gov (United States)

    Ulrich, Dave; Smallwood, Norm

    2004-06-01

    By making the most of organizational capabilities--employees' collective skills and fields of expertise--you can dramatically improve your company's market value. Although there is no magic list of proficiencies that every organization needs in order to succeed, the authors identify 11 intangible assets that well-managed companies tend to have: talent, speed, shared mind-set and coherent brand identity, accountability, collaboration, learning, leadership, customer connectivity, strategic unity, innovation, and efficiency. Such companies typically excel in only three of these capabilities while maintaining industry parity in the other areas. Organizations that fall below the norm in any of the 11 are likely candidates for dysfunction and competitive disadvantage. So you can determine how your company fares in these categories (or others, if the generic list doesn't suit your needs), the authors explain how to conduct a "capabilities audit," describing in particular the experiences and findings of two companies that recently performed such audits. In addition to highlighting which intangible assets are most important given the organization's history and strategy, this exercise will gauge how well your company delivers on its capabilities and will guide you in developing an action plan for improvement. A capabilities audit can work for an entire organization, a business unit, or a region--indeed, for any part of a company that has a strategy to generate financial or customer-related results. It enables executives to assess overall company strengths and weaknesses, senior leaders to define strategy, midlevel managers to execute strategy, and frontline leaders to achieve tactical results. In short, it helps turn intangible assets into concrete strengths.

  20. Atmospheric Release Advisory Capability

    International Nuclear Information System (INIS)

    Dickerson, M.H.; Gudiksen, P.H.; Sullivan, T.J.

    1983-02-01

    The Atmospheric Release Advisory Capability (ARAC) project is a Department of Energy (DOE) sponsored real-time emergency response service available for use by both federal and state agencies in case of a potential or actual atmospheric release of nuclear material. The project, initiated in 1972, is currently evolving from the research and development phase to full operation. Plans are underway to expand the existing capability to continuous operation by 1984 and to establish a National ARAC Center (NARAC) by 1988. This report describes the ARAC system, its utilization during the past two years, and plans for its expansion during the next five to six years. An integral part of this expansion is due to a very important and crucial effort sponsored by the Defense Nuclear Agency to extend the ARAC service to approximately 45 Department of Defense (DOD) sites throughout the continental US over the next three years

  1. Group Capability Model

    Science.gov (United States)

    Olejarski, Michael; Appleton, Amy; Deltorchio, Stephen

    2009-01-01

    The Group Capability Model (GCM) is a software tool that allows an organization, from first line management to senior executive, to monitor and track the health (capability) of various groups in performing their contractual obligations. GCM calculates a Group Capability Index (GCI) by comparing actual head counts, certifications, and/or skills within a group. The model can also be used to simulate the effects of employee usage, training, and attrition on the GCI. A universal tool and common method was required due to the high risk of losing skills necessary to complete the Space Shuttle Program and meet the needs of the Constellation Program. During this transition from one space vehicle to another, the uncertainty among the critical skilled workforce is high and attrition has the potential to be unmanageable. GCM allows managers to establish requirements for their group in the form of head counts, certification requirements, or skills requirements. GCM then calculates a Group Capability Index (GCI), where a score of 1 indicates that the group is at the appropriate level; anything less than 1 indicates a potential for improvement. This shows the health of a group, both currently and over time. GCM accepts as input head count, certification needs, critical needs, competency needs, and competency critical needs. In addition, team members are categorized by years of experience, percentage of contribution, ex-members and their skills, availability, function, and in-work requirements. Outputs are several reports, including actual vs. required head count, actual vs. required certificates, CGI change over time (by month), and more. The program stores historical data for summary and historical reporting, which is done via an Excel spreadsheet that is color-coded to show health statistics at a glance. GCM has provided the Shuttle Ground Processing team with a quantifiable, repeatable approach to assessing and managing the skills in their organization. They now have a common

  2. Expeditionary Rubber Removal Capability

    Science.gov (United States)

    2006-12-31

    the modified spray unit or system with equivalent capabilities. 24 25 9.8. A pressure sensor or caster wheels should be incorporated into the...DISCUSSION 18 8.0 CONCLUSIONS 23 9.0 RECOMMENDATIONS 24 APPENDIX A – DETAILED LIST OF EQUIPMENT AND MODIFICATIONS 26 APPENDIX B – LIST OF SOURCES FOR...tall Weight – 4820 lb (No Attachments) Top Speed – 18 mph High Flow Hydraulics (Optional) – 26 gpm Steering – All Wheel Steering Cargo Max Load

  3. Atmospheric release advisory capability

    International Nuclear Information System (INIS)

    Sullivan, T.J.

    1981-01-01

    The ARAC system (Atmospheric Release Advisory Capability) is described. The system is a collection of people, computers, computer models, topographic data and meteorological input data that together permits a calculation of, in a quasi-predictive sense, where effluent from an accident will migrate through the atmosphere, where it will be deposited on the ground, and what instantaneous and integrated dose an exposed individual would receive

  4. Medical Certification System -

    Data.gov (United States)

    Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

  5. The evolution of alliance capabilities

    NARCIS (Netherlands)

    Heimeriks, K.H.; Duysters, G.M.; Vanhaverbeke, W.P.M.

    2004-01-01

    This paper assesses the effectiveness and differential performance effects of learning mechanisms on the evolution of alliance capabilities. Relying on the concept of capability lifecycles, prior research has suggested that different capability levels could be identified in which different

  6. Health and medical research funding agencies' promotion of public engagement within research: a qualitative interview study exploring the United Kingdom context.

    Science.gov (United States)

    van Bekkum, Jennifer E; Fergie, Gillian M; Hilton, Shona

    2016-03-24

    Public engagement (PE) has become a common feature of many liberal governmental agendas worldwide. Since the turn of this century there has been a succession of United Kingdom policy initiatives to encourage research funding agencies, universities and researchers to reconsider how they engage with citizens and communities. Although most funding agencies now explicitly promote PE within research, little empirical work has been carried out in this area. In this study, we explored why and how health and medical research funding agencies in the United Kingdom have interpreted and implemented their role to promote PE within research. Semi-structured interviews were carried out with 30 key informants from 10 agencies that fund health or medical research. Data were also gathered from agencies' websites and documentation. The analysis was based on the constant comparative method. Across agencies, we found that PE was being interpreted and operationalised in various different ways. The terminology used within funding agencies to describe PE seems to be flexibly applied. Disciplinary differences were evident both in the terminology used to describe PE and the drivers for PE highlighted by participants - with applied health science funders more aligned with participatory models of PE. Within the grant funding process PE was rarely systematically treated as a key component of research. In particular, PE was not routinely incorporated into the planning of funding calls. PE was more likely to be considered in the application and assessment phases, where it was largely appraised as a tool for enhancing science. Concerns were expressed regarding how to monitor and evaluate PE within research. This study suggests funding agencies working within specific areas of health and medicine can promote particular definitions of PE and aligned practices which determine the boundaries in which researchers working in these areas understand and practice PE. Our study also highlights how the

  7. Building Server Capabilities

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi

    2013-01-01

    Many western companies have moved part of their operations to China in order to take advantage of cheap resources and/or to gain access to a high potential market. Depending on motive, offshore facilities usually start either as “sales-only” of products exported by headquarters or “production......-only”, exporting parts and components back to headquarter for sales in the home country. In the course of time, the role of offshore subsidiaries in a company’s operations network tends to change and, with that, the capabilities, of the subsidiaries. Focusing on Danish subsidiaries in China, the objective...

  8. Building server capabilities

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi

    Many western companies have moved part of their operations to China in order to take advantage of cheap resources and/or to gain access to a high potential market. Depending on motive, offshore facilities usually start either as “sales-only” of products exported by headquarters or “production......-only”, exporting parts and components back to headquarter for sales in the home country. In the course of time, the role of offshore subsidiaries in a company’s operations network tends to change and, with that, the capabilities, of the subsidiaries. Focusing on Danish subsidiaries in China, the objective...

  9. Integrated Medical Model Overview

    Science.gov (United States)

    Myers, J.; Boley, L.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.; Saile, L.; hide

    2015-01-01

    The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project.

  10. THE SISYPHEAN MYTH, NEGATIVE CAPABILITY AND SOCIETAL ...

    African Journals Online (AJOL)

    mycl

    Capability suggest solutions to Camus' Sisyphean problem and its ilk. This paper explores this ... Framed us in jest, and left us now to hazardry? ... and right'; this being one half of a saying meant to create value for a soldier's sacrifice of his ... Keats made an interesting observation and propounded the theory of. 'Negative ...

  11. Laboratory microfusion capability study

    International Nuclear Information System (INIS)

    1993-05-01

    The purpose of this study is to elucidate the issues involved in developing a Laboratory Microfusion Capability (LMC) which is the major objective of the Inertial Confinement Fusion (ICF) program within the purview of the Department of Energy's Defense Programs. The study was initiated to support a number of DOE management needs: to provide insight for the evolution of the ICF program; to afford guidance to the ICF laboratories in planning their research and development programs; to inform Congress and others of the details and implications of the LMC; to identify criteria for selection of a concept for the Laboratory Microfusion Facility and to develop a coordinated plan for the realization of an LMC. As originally proposed, the LMC study was divided into two phases. The first phase identifies the purpose and potential utility of the LMC, the regime of its performance parameters, driver independent design issues and requirements, its development goals and requirements, and associated technical, management, staffing, environmental, and other developmental and operational issues. The second phase addresses driver-dependent issues such as specific design, range of performance capabilities, and cost. The study includes four driver options; the neodymium-glass solid state laser, the krypton fluoride excimer gas laser, the light-ion accelerator, and the heavy-ion induction linear accelerator. The results of the Phase II study are described in the present report

  12. A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers.

    Science.gov (United States)

    Muller-Juge, Virginie; Pereira Miozzari, Anne Catherine; Rieder, Arabelle; Hasselgård-Rowe, Jennifer; Sommer, Johanna; Audétat, Marie-Claude

    2018-01-01

    The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach. The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities. These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students' academic training and the skills needed for outpatient care. Professionalizing the role of clinical teachers should contribute to reaching these goals.

  13. Intelligent distributed medical image management

    Science.gov (United States)

    Garcia, Hong-Mei C.; Yun, David Y.

    1995-05-01

    The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

  14. Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics.

    Science.gov (United States)

    Or, Calvin; Tong, Ellen; Tan, Joseph; Chan, Summer

    2018-05-29

    The health care reform initiative led by the Hong Kong government's Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients' health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users' and organizations' needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users' information technology literacy; training and technical support; and social and organizational influences. The

  15. Evaluating Internal Technological Capabilities in Energy Companies

    Directory of Open Access Journals (Sweden)

    Mingook Lee

    2016-03-01

    Full Text Available As global competition increases, technological capability must be evaluated objectively as one of the most important factors for predominance in technological competition and to ensure sustainable business excellence. Most existing capability evaluation models utilize either quantitative methods, such as patent analysis, or qualitative methods, such as expert panels. Accordingly, they may be in danger of reflecting only fragmentary aspects of technological capabilities, and produce inconsistent results when different models are used. To solve these problems, this paper proposes a comprehensive framework for evaluating technological capabilities in energy companies by considering the complex properties of technological knowledge. For this purpose, we first explored various factors affecting technological capabilities and divided the factors into three categories: individual, organizational, and technology competitiveness. Second, we identified appropriate evaluation items for each category to measure the technological capability. Finally, by using a hybrid approach of qualitative and quantitative methods, we developed an evaluation method for each item and suggested a method to combine the results. The proposed framework was then verified with an energy generation and supply company to investigate its practicality. As one of the earliest attempts to evaluate multi-faceted technological capabilities, the suggested model can support technology and strategic planning.

  16. Remediation of at-risk medical students: theory in action

    OpenAIRE

    Winston, K.A.; Vleuten, C.P.M. van der; Scherpbier, A.J.J.A.

    2013-01-01

    BACKGROUND: Previous work has shown that a programme that draws on a blend of theories makes a positive difference to outcomes for students who fail and repeat their first semester at medical school. Exploration of student and teacher perspectives revealed that remediation of struggling medical students can be achieved through a cognitive apprenticeship within a small community of inquiry. This community needs expert teachers capable of performing a unique combination of roles (facilitator, n...

  17. Aircraft Capability Management

    Science.gov (United States)

    Mumaw, Randy; Feary, Mike

    2018-01-01

    This presentation presents an overview of work performed at NASA Ames Research Center in 2017. The work concerns the analysis of current aircraft system management displays, and the initial development of an interface for providing information about aircraft system status. The new interface proposes a shift away from current aircraft system alerting interfaces that report the status of physical components, and towards displaying the implications of degradations on mission capability. The proposed interface describes these component failures in terms of operational consequences of aircraft system degradations. The research activity was an effort to examine the utility of different representations of complex systems and operating environments to support real-time decision making of off-nominal situations. A specific focus was to develop representations that provide better integrated information to allow pilots to more easily reason about the operational consequences of the off-nominal situations. The work is also seen as a pathway to autonomy, as information is integrated and understood in a form that automated responses could be developed for the off-nominal situations in the future.

  18. Production capability and supply

    International Nuclear Information System (INIS)

    Klemenic, J.

    1977-01-01

    The strong market for uranium of recent years is about to usher in a new era in domestic uranium production. The spot market price of uranium has remained relatively stable at a little over $40/lb for more than 18 months. Many of the recent contracts for delivery in the early 1980s are calling for prices in the range of $40 to $65 per lb in year-of-delivery dollars. Low-grade, high-cost projects, such as uranium recovery from mill tailings and the reopening of ''mined-out'' ore bodies, have already been initiated. New underground mines to produce at greater depths, and new surface mines to recover lower grade ores, are being developed or seriously planned. In keeping with this movement to recover uranium from low-grade ore and other high cost materials, the Grand Junction Office has examined, for the first time, the production capability of the domestic industry assuming a $30/lb (or less) ''forward cost'' resource base. As in the past, keep in mind that the market price needed to stimulate full production of a given resource base may be significantly higher than the estimated forward cost of producing that resource. Results of the $30/lb study are presented

  19. LHC Capabilities for Quarkonia

    CERN Document Server

    Petrushanko, Sergey

    2008-01-01

    The measurement of the charmonium and bottomonium resonances in nucleus-nucleus collisions provides crucial information on high-density QCD matter. First, the suppression of quarkonia production is generally agreed to be one of the most direct probes of quark-gluon plasma formation. The observation of anomalous J/$\\psi$ suppression at the CERN-SPS and at RHIC is well established but the clarification of some important remaining questions requires equivalent studies of the $\\Upsilon$ family, only possible at the LHC energies. Second, the production of heavy-quarks proceeds mainly via gluon-gluon fusion processes and, as such, is sensitive to saturation of the gluon density at low-x in the nucleus. Measured departures from the expected vacuum quarkonia cross-sections in Pb+Pb collisions at the LHC will thus provide valuable information not only on the thermodynamical state of the produced partonic medium, but also on the initial-state modifications of the nuclear parton distribution functions. The capabilities ...

  20. Mobile systems capability plan

    International Nuclear Information System (INIS)

    1996-09-01

    This plan was prepared to initiate contracting for and deployment of these mobile system services. 102,000 cubic meters of retrievable, contact-handled TRU waste are stored at many sites around the country. Also, an estimated 38,000 cubic meters of TRU waste will be generated in the course of waste inventory workoff and continuing DOE operations. All the defense TRU waste is destined for disposal in WIPP near Carlsbad NM. To ship TRU waste there, sites must first certify that the waste meets WIPP waste acceptance criteria. The waste must be characterized, and if not acceptable, subjected to additional processing, including repackaging. Most sites plan to use existing fixed facilities or open new ones between FY1997-2006 to perform these functions; small-quantity sites lack this capability. An alternative to fixed facilities is the use of mobile systems mounted in trailers or skids, and transported to sites. Mobile systems will be used for all characterization and certification at small sites; large sites can also use them. The Carlsbad Area Office plans to pursue a strategy of privatization of mobile system services, since this offers a number of advantages. To indicate the possible magnitude of the costs of deploying mobile systems, preliminary estimates of equipment, maintenance, and operating costs over a 10-year period were prepared and options for purchase, lease, and privatization through fixed-price contracts considered

  1. Strength capability while kneeling.

    Science.gov (United States)

    Haslegrave, C M; Tracy, M F; Corlett, E N

    1997-12-01

    Work sometimes has to be carried out kneeling, particularly where jobs are performed in confined spaces as is common for miners, aircraft baggage handlers and maintenance workers. In order to assess the risks in performing forceful tasks under such conditions, data is needed on strength capabilities of kneeling subjects. A study was undertaken to measure isometric strength in single-handed exertions for male subjects and to investigate the effects on this of task layout factors (direction of force exertion, reach distance, height of the workpiece and orientation relative to the subject's sagittal plane). The data has been tabulated to show the degree to which strength may be reduced in different situations and analysis of the task factors showed their influence to be complex with direction of exertion and reach distance having the greatest effect. The results also suggest that exertions are weaker when subjects are kneeling on two knees than when kneeling on one knee, although this needs to be confirmed by direct experimental comparison.

  2. A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers

    Directory of Open Access Journals (Sweden)

    Muller-Juge V

    2017-12-01

    Full Text Available Virginie Muller-Juge, Anne Catherine Pereira Miozzari, Arabelle Rieder, Jennifer Hasselgård-Rowe, Johanna Sommer, Marie-Claude Audétat Unit of Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland Purpose: The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians’ private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva.Methods: Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach.Results: The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities.Conclusion: These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students’ academic training and the skills needed for

  3. Exploring imaging capabilities of the extended prestack wavefield

    KAUST Repository

    Alkhalifah, Tariq Ali

    2013-08-19

    The dynamic form of the double square-root (DSR) equation provides a mechanism to extrapolate prestack wavefields by moving the sources and receivers in space with respect to a potential image (scatterer) point. Its classical implementation for imaging often assumes sources and receivers are at the same horizontal surface. Reverse time migration (RTM), as well as common shot migrations in general, through its separate treatment of the sources and receivers, allows for more exibility in source and receiver configurations. A simple modication to the classical DSR equation provides such exibility. Specically, we define a 7-dimensional prestack wavefield for 3-D media that includes the vertical source and receiver offset. The corresponding dispersion relation can be used to extrapolate such wavefields. However, the cost for such a definition and extrapolation can be prohibitive, considering the high dimensionality of the problem. We reduce the dimensionality by recognizing that the sources and receivers often share the same horizontal plane, and thus, obtain the conventional DSR formulation. An efficient implementation of DSR in time yields extrapolation speeds that nominally exceed those obtained from reverse time migration. We can also reduce the dimensionality by setting the horizontal offset between the source and receiver at the image point to zero, or using a DSR-like formulation to correct for source-receiver vertical offset or topography.

  4. Advanced Nuclear Fuels for More Capable and Sustainable Exploration

    Data.gov (United States)

    National Aeronautics and Space Administration — Molten salt reactors are a subtype of reactor that uses nuclear fuel dissolved in a molten salt liquid medium (such as LiF-BeF2-UF4) as both fuel and coolant. The...

  5. OHB's Exploration Capabilities Overview Relevant to Mars Sample Return Mission

    Science.gov (United States)

    Jaime, A.; Gerth, I.; Rohrbeck, M.; Scheper, M.

    2018-04-01

    The presentation will give an overview to all the OHB past and current projects that are relevant to the Mars Sample Return (MSR) mission, including some valuable lessons learned applicable to the upcoming MSR mission.

  6. Exploring imaging capabilities of the extended prestack wavefield

    KAUST Repository

    Alkhalifah, Tariq Ali; Wu, Zedong; Fomel, Sergey

    2013-01-01

    The dynamic form of the double square-root (DSR) equation provides a mechanism to extrapolate prestack wavefields by moving the sources and receivers in space with respect to a potential image (scatterer) point. Its classical implementation for imaging often assumes sources and receivers are at the same horizontal surface. Reverse time migration (RTM), as well as common shot migrations in general, through its separate treatment of the sources and receivers, allows for more exibility in source and receiver configurations. A simple modication to the classical DSR equation provides such exibility. Specically, we define a 7-dimensional prestack wavefield for 3-D media that includes the vertical source and receiver offset. The corresponding dispersion relation can be used to extrapolate such wavefields. However, the cost for such a definition and extrapolation can be prohibitive, considering the high dimensionality of the problem. We reduce the dimensionality by recognizing that the sources and receivers often share the same horizontal plane, and thus, obtain the conventional DSR formulation. An efficient implementation of DSR in time yields extrapolation speeds that nominally exceed those obtained from reverse time migration. We can also reduce the dimensionality by setting the horizontal offset between the source and receiver at the image point to zero, or using a DSR-like formulation to correct for source-receiver vertical offset or topography.

  7. TBEST model enhancements : parcel level demographic data capabilities and exploration of enhanced trip attraction capabilities.

    Science.gov (United States)

    2011-09-01

    "FDOT, in pursuit of its role to assist in providing public transportation services in Florida, has made a substantial : research investment in a travel demand forecasting tool for public transportation known as Transit Boardings : Estimation and Sim...

  8. Assessing organizational readiness for depression care quality improvement: relative commitment and implementation capability.

    Science.gov (United States)

    Rubenstein, Lisa V; Danz, Marjorie S; Crain, A Lauren; Glasgow, Russell E; Whitebird, Robin R; Solberg, Leif I

    2014-12-02

    Depression is a major cause of morbidity and cost in primary care patient populations. Successful depression improvement models, however, are complex. Based on organizational readiness theory, a practice's commitment to change and its capability to carry out the change are both important predictors of initiating improvement. We empirically explored the links between relative commitment (i.e., the intention to move forward within the following year) and implementation capability. The DIAMOND initiative administered organizational surveys to medical and quality improvement leaders from each of 83 primary care practices in Minnesota. Surveys preceded initiation of activities directed at implementation of a collaborative care model for improving depression care. To assess implementation capability, we developed composites of survey items for five types of organizational factors postulated to be collaborative care barriers and facilitators. To assess relative commitment for each practice, we averaged leader ratings on an identical survey question assessing practice priorities. We used multivariable regression analyses to assess the extent to which implementation capability predicted relative commitment. We explored whether relative commitment or implementation capability measures were associated with earlier initiation of DIAMOND improvements. All five implementation capability measures independently predicted practice leaders' relative commitment to improving depression care in the following year. These included the following: quality improvement culture and attitudes (p = 0.003), depression culture and attitudes (p commitment (p = 0.002) and prior depression quality improvement activities appeared to be associated with earlier participation in the DIAMOND initiative. The study supports the concept of organizational readiness to improve quality of care and the use of practice leader surveys to assess it. Practice leaders' relative commitment to depression care

  9. HR Explorer

    CERN Document Server

    Möller, M

    1997-01-01

    At the European Laboratory for Particle Physics Research (CERN), Geneva Switzerland we are using OracleHR for managing our human resources since 1995. After the first year of production it became clear that there was a strong need for an easy-to-use Decision Support Tool exploring the data in OracleHR. This paper illustrates an approach which we have adopted to provide on-line management reporting, multi-dimensional analysis, drill-down and slicing & dicing of data, warehoused from OracleHR. The tool offers strong resource management and planning capabilities including career follow-up. The user management and security monitoring are implemented using the Oracle WebServer.

  10. Sandia Laboratories technical capabilities. Auxiliary capabilities: environmental health information science

    International Nuclear Information System (INIS)

    1975-09-01

    Sandia Laboratories is an engineering laboratory in which research, development, testing, and evaluation capabilities are integrated by program management for the generation of advanced designs. In fulfilling its primary responsibility to ERDA, Sandia Laboratories has acquired extensive research and development capabilities. The purpose of this series of documents is to catalog the many technical capabilities of the Laboratories. After the listing of capabilities, supporting information is provided in the form of highlights, which show applications. This document deals with auxiliary capabilities, in particular, environmental health and information science. (11 figures, 1 table) (RWR)

  11. Sandia Laboratories technical capabilities: testing

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-12-01

    The testing capabilities at Sandia Laboratories are characterized. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  12. Sandia Laboratories technical capabilities: electronics

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-12-01

    This report characterizes the electronics capabilities at Sandia Laboratories. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  13. Structural Capability of an Organization toward Innovation Capability

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Momeni, Mostafa

    2016-01-01

    The scholars in the field of strategic management have developed two major approaches for attainment of competitive advantage: an approach based on environmental opportunities, and another one based on internal capabilities of an organization. Some investigations in the last two decades have...... indicated that the advantages relying on the internal capabilities of organizations may determine the competitive position of organizations better than environmental opportunities do. Characteristics of firms shows that one of the most internal capabilities that lead the organizations to the strongest...... competitive advantage in the organizations is the innovation capability. The innovation capability is associated with other organizational capabilities, and many organizations have focused on the need to identify innovation capabilities.This research focuses on recognition of the structural aspect...

  14. The Capability to Hold Property

    NARCIS (Netherlands)

    Claassen, Rutger

    2015-01-01

    This paper discusses the question of whether a capability theory of justice (such as that of Martha Nussbaum) should accept a basic “capability to hold property.” Answering this question is vital for bridging the gap between abstract capability theories of justice and their institutional

  15. Dynamic capabilities, creative action, and poetics

    Directory of Open Access Journals (Sweden)

    Donald MacLean

    2017-05-01

    Full Text Available Research on dynamic capabilities explores how businesses change enables enterprises to remain competitive. However, theory on dynamic capabilities still struggles to capture novelty, the essence of change. This study argues that a full understanding of strategic change requires us to sharpen our focus on real people and experiences; in turn, we must incorporate other faculties, which almost always operate alongside our logical ones, into our theory. We must pay more attention to the “non­-rational” sides of ourselves—including, but not limited to, our imaginations, intuitions, attractions, biographies, preferences, and aesthetic faculties and capabilities. We argue that all such faculties, on the one hand, are central to our abilities to comprehend and cope with complexity and, on the other hand, foster novel understandings, potential responses, and social creativity. This study intro­duces the possibility of an alternative form of inquiry that highlights the role of poetic faculties in strategic behavior and change.

  16. Capability-based computer systems

    CERN Document Server

    Levy, Henry M

    2014-01-01

    Capability-Based Computer Systems focuses on computer programs and their capabilities. The text first elaborates capability- and object-based system concepts, including capability-based systems, object-based approach, and summary. The book then describes early descriptor architectures and explains the Burroughs B5000, Rice University Computer, and Basic Language Machine. The text also focuses on early capability architectures. Dennis and Van Horn's Supervisor; CAL-TSS System; MIT PDP-1 Timesharing System; and Chicago Magic Number Machine are discussed. The book then describes Plessey System 25

  17. Cost-effectiveness of Antihypertensive Medication: Exploring Race and Sex Differences Using Data From the REasons for Geographic and Racial Differences in Stroke Study.

    Science.gov (United States)

    Tajeu, Gabriel S; Mennemeyer, Stephen; Menachemi, Nir; Weech-Maldonado, Robert; Kilgore, Meredith

    2017-06-01

    Antihypertensive medication decreases risk of cardiovascular disease (CVD) events in adults with hypertension. Although black adults have higher prevalence of hypertension and worse CVD outcomes compared with whites, limited attention has been given to the cost-effectiveness of antihypertensive medication for blacks. To compare the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. We constructed a State Transition Model to assess the costs and quality-adjusted life-years (QALYs) associated with either antihypertensive medication treatment or no-treatment using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study and published literature. CVD events and health states considered in the model included stroke, coronary heart disease, heart failure, chronic kidney disease, and end-stage renal disease. White and black adults with hypertension in the United States, 45 years of age and above. Yearly risk of CVD was determined using REGARDS data and published literature. Antihypertensive medication costs were determined using Medicare claims. Event and health state costs were estimated from published literature. All costs were adjusted to 2012 US dollars. Effectiveness was assessed using QALYs. Antihypertensive medication treatment was cost-saving and increased QALYs compared with no-treatment for white men ($7387; 1.14 QALYs), white women ($7796; 0.89 QALYs), black men ($8400; 1.66 QALYs), and black women ($10,249; 1.79 QALYs). Antihypertensive medication treatment is cost-saving and increases QALYs for all groups considered in the model, particularly among black adults.

  18. Transforming organizational capabilities in strategizing

    DEFF Research Database (Denmark)

    Jørgensen, Claus; Friis, Ole Uhrskov; Koch, Christian

    2014-01-01

    Offshored and networked enterprises are becoming an important if not leading organizational form and this development seriously challenges their organizational capabilities. More specifically, over the last years, SMEs have commenced entering these kinds of arrangements. As the organizational...... capabilities of SMEs are limited at the outset, even more emphasis is needed regarding the issues of developing relevant organizational capabilities. This paper aims at investigating how capabilities evolve during an offshoring process of more than 5 years in two Danish SMEs, i.e. not only short- but long......-term evolvements within the companies. We develop our framework of understanding organizational capabilities drawing on dynamic capability, relational capability and strategy as practice concepts, appreciating the performative aspects of developing new routines. Our two cases are taken from one author’s Ph...

  19. Physician capability to electronically exchange clinical information, 2011.

    Science.gov (United States)

    Patel, Vaishali; Swain, Matthew J; King, Jennifer; Furukawa, Michael F

    2013-10-01

    To provide national estimates of physician capability to electronically share clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors using the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement. Survey of a nationally representative sample of nonfederal office-based physicians who provide direct patient care. The survey was administered by mail with telephone follow-up and had a 61% weighted response rate. The overall sample consisted of 4326 respondents. We calculated estimates of electronic exchange capability at the national and state levels, and applied multivariate analyses to examine the association between the capability to exchange different types of clinical information and physician and practice characteristics. In 2011, 55% of physicians had computerized capability to send prescriptions electronically; 67% had the capability to view lab results electronically; 42% were able to incorporate lab results into their EHR; 35% were able to send lab orders electronically; and, 31% exchanged patient clinical summaries with other providers. The strongest predictor of exchange capability is adoption of an EHR. However, substantial variation exists across geography and EHR vendors in exchange capability, especially electronic exchange of clinical summaries. In 2011, a majority of office-based physicians could exchange lab and medication data, and approximately one-third could exchange clinical summaries with patients or other providers. EHRs serve as a key mechanism by which physicians can exchange clinical data, though physicians' capability to exchange varies by vendor and by state.

  20. The Pathway to a Safe and Effective Spaceflight Medication Formulary: Expert Review Panel Recommendations

    Science.gov (United States)

    Daniels, V. R.; Bayuse, T. M.; Mulcahy, R. A.; McGuire, R. K. M.; Antonsen, E. L.

    2018-01-01

    Exploration spaceflight poses several challenges to the provision of a comprehensive medication formulary. This formulary must accommodate the size and space limitations of the spacecraft, while addressing individual medication needs and preferences of the crew, consequences of a degrading inventory over time, the inability to resupply used or expired medications, and the need to forecast the best possible medication candidates to treat conditions that may occur. The Exploration Medical Capability (ExMC) Element's Pharmacy Project Team has developed a research plan (RP) that is focused on evidence-based models and theories as well as new diagnostic tools, treatments, or preventive measures aimed to ensure an available, safe, and effective pharmacy sufficient to manage potential medical threats during exploration spaceflight. Here, we will discuss the ways in which the ExMC Pharmacy Project Team pursued expert evaluation and guidance, and incorporated acquired insight into an achievable research pathway, reflected in the revised RP.

  1. The Evolution of Medical Training Simulation in the U.S. Military.

    Science.gov (United States)

    Linde, Amber S; Kunkler, Kevin

    2016-01-01

    The United States has been at war since 2003. During that time, training using Medical Simulation technology has been developed and integrated into military medical training for combat medics, nurses and surgeons. Efforts stemming from the Joint Programmatic Committee-1 (JPC-1) Medical Simulation and Training Portfolio has allowed for the improvement and advancement in military medical training by focusing on research in simulation training technology in order to achieve this. Based upon lessons learned capability gaps have been identified concerning the necessity to validate and enhance combat medial training simulators. These capability gaps include 1) Open Source/Open Architecture; 2) Modularity and Interoperability; and 3) Material and Virtual Reality (VR) Models. Using the capability gaps, JPC-1 has identified important research endeavors that need to be explored.

  2. Impact of Personnel Capabilities on Organizational Innovation Capability

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Momeni, Mostafa

    2016-01-01

    in this rapidly changing world. This research focuses on definition of the personnel aspect of innovation capability, and proposes a conceptual model based on the scientific articles of academic literature on organisations innovation capability. This paper includes an expert based validation in three rounds...... of the Delphi method. And for the purpose of a better appreciation of the relationship dominating the factors of the model, it has distributed the questionnaire to Iranian companies in the Food industry. This research proposed a direct relationship between Innovation Capability and the Personnel Capability...

  3. Prototype Development of a Tradespace Analysis Tool for Spaceflight Medical Resources.

    Science.gov (United States)

    Antonsen, Erik L; Mulcahy, Robert A; Rubin, David; Blue, Rebecca S; Canga, Michael A; Shah, Ronak

    2018-02-01

    The provision of medical care in exploration-class spaceflight is limited by mass, volume, and power constraints, as well as limitations of available skillsets of crewmembers. A quantitative means of exploring the risks and benefits of inclusion or exclusion of onboard medical capabilities may help to inform the development of an appropriate medical system. A pilot project was designed to demonstrate the utility of an early tradespace analysis tool for identifying high-priority resources geared toward properly equipping an exploration mission medical system. Physician subject matter experts identified resources, tools, and skillsets required, as well as associated criticality scores of the same, to meet terrestrial, U.S.-specific ideal medical solutions for conditions concerning for exploration-class spaceflight. A database of diagnostic and treatment actions and resources was created based on this input and weighed against the probabilities of mission-specific medical events to help identify common and critical elements needed in a future exploration medical capability. Analysis of repository data demonstrates the utility of a quantitative method of comparing various medical resources and skillsets for future missions. Directed database queries can provide detailed comparative estimates concerning likelihood of resource utilization within a given mission and the weighted utility of tangible and intangible resources. This prototype tool demonstrates one quantitative approach to the complex needs and limitations of an exploration medical system. While this early version identified areas for refinement in future version development, more robust analysis tools may help to inform the development of a comprehensive medical system for future exploration missions.Antonsen EL, Mulcahy RA, Rubin D, Blue RS, Canga MA, Shah R. Prototype development of a tradespace analysis tool for spaceflight medical resources. Aerosp Med Hum Perform. 2018; 89(2):108-114.

  4. Governance capabilities for dealing wisely with wicked problems

    NARCIS (Netherlands)

    Termeer, C.J.A.M.; Dewulf, A.; Breeman, G.E.; Stiller, S.J.

    2015-01-01

    This article explores an integrative approach for dealing with wicked problems. Wicked problems not only require alternative action strategies but also alternative ways of observing and enabling. Four governance capabilities are essential: (a) reflexivity, or the capability to deal with multiple

  5. System Reliability Analysis Capability and Surrogate Model Application in RAVEN

    Energy Technology Data Exchange (ETDEWEB)

    Rabiti, Cristian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Alfonsi, Andrea [Idaho National Lab. (INL), Idaho Falls, ID (United States); Huang, Dongli [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gleicher, Frederick [Idaho National Lab. (INL), Idaho Falls, ID (United States); Wang, Bei [Idaho National Lab. (INL), Idaho Falls, ID (United States); Adbel-Khalik, Hany S. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Pascucci, Valerio [Idaho National Lab. (INL), Idaho Falls, ID (United States); Smith, Curtis L. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-11-01

    This report collect the effort performed to improve the reliability analysis capabilities of the RAVEN code and explore new opportunity in the usage of surrogate model by extending the current RAVEN capabilities to multi physics surrogate models and construction of surrogate models for high dimensionality fields.

  6. Common market but divergent regulatory practices: exploring European regulation and the effect on regulatory uncertainty in the marketing authorization of medical products

    NARCIS (Netherlands)

    Chowdhury, Nupur

    2013-01-01

    The medical product sector is characterised by a regulatory patchwork of European and national laws and guidelines operating concurrently with each other. Each of these sectors are characterised by different levels of regulatory uncertainty that may undermine the effectiveness of the regulatory

  7. Exploring Learner Acceptance of the Use of Virtual Reality in Medical Education: A Case Study of Desktop and Projection-Based Display Systems

    Science.gov (United States)

    Huang, Hsiu-Mei; Liaw, Shu-Sheng; Lai, Chung-Min

    2016-01-01

    Advanced technologies have been widely applied in medical education, including human-patient simulators, immersive virtual reality Cave Automatic Virtual Environment systems, and video conferencing. Evaluating learner acceptance of such virtual reality (VR) learning environments is a critical issue for ensuring that such technologies are used to…

  8. Can you snooze your way to an 'A'? Exploring the complex relationship between sleep, autonomic activity, wellbeing and performance in medical students.

    Science.gov (United States)

    Cvejic, Erin; Huang, Shiny; Vollmer-Conna, Uté

    2018-01-01

    Medical training brings with it multiple stressors, including demanding workloads in highly competitive environments, with well-documented impact on psychiatric morbidity. This study evaluated the impact of sleep-related factors on psychological wellbeing, cognitive task performance and academic standing in medical students. A total of 59 undergraduate medical students took part in this cross-sectional study over two consecutive days. Participants responded to questionnaires about their physical and psychological health, sleep, functioning and academic performance at the initial visit. Participants then wore an ambulatory bioharness overnight (to derive heart rate variability measures), before returning to complete a computerised battery of cognitive tasks. A sleep diary was completed for the next 7 days. Poor sleep quality in the month preceding assessment correlated with psychological distress ( p sleep during the monitoring week ( p sleep timing parameters. A greater increase in heart rate variability during the transition from awake to sleep significantly predicted better spontaneous cognitive performance ( p = 0.021). Better academic standing was predicted by consistently short, less refreshing sleep (all p sleep and psychological distress are prevalent in medical students during university training and were associated with reduced nocturnal parasympathetic autonomic activity. Achieving higher academic grades was associated with high psychological wellbeing despite consistently short, unrefreshing sleep. The long-term repercussions of such sleep behaviours on later professional functioning remain unclear, warranting further research.

  9. People Capability Maturity Model. SM.

    Science.gov (United States)

    1995-09-01

    tailored so it consumes less time and resources than a traditional software process assessment or CMU/SEI-95-MM-02 People Capability Maturity Model...improved reputation or customer loyalty. CMU/SEI-95-MM-02 People Capability Maturity Model ■ L5-17 Coaching Level 5: Optimizing Activity 1...Maturity Model CMU/SEI-95-MM-62 Carnegie-Mellon University Software Engineering Institute DTIC ELECTE OCT 2 7 1995 People Capability Maturity

  10. Building New Education Model to Enhance the Comprehensive Competence of the Medical Students The exploration of PRICE Education Model in School of Medicine, Shanghai Jiao Tong University

    Institute of Scientific and Technical Information of China (English)

    Gang Huang; Bingjie Lu; Jifeng Fu; Yanping Zhang; Wenhan Mei; Yan Li; Yifei Wang

    2014-01-01

    To enhance the competence of medical students, Shanghai Jiao Tong University School of Medicine innovates the new PRICE education model, through Problem-based Learning(P) and Research-based learning(R), guides the students to give full play to the active learning; break the traditional discipline-centered teaching model by an integrated curriculum(I),combines with clinical practice-based learning(C) to solve the disjointed question between the basic theory and clinical practice in medical education, uses the comprehensive evaluation system(E) to assess the learning effect of the students and the quality of the teaching. The PRICE education model is verified by our educational practice.

  11. Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity.

    Science.gov (United States)

    Hulsman, Robert L; van der Vloodt, Jane

    2015-03-01

    Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video recorded communication skills were analyzed. Twenty-five year 4 medical students recorded history-taking consultations with a simulated patient, uploaded the video to a web-based platform, marked and annotated positive and negative events. Peers reviewed the video and self-evaluations and provided feedback. Analyzed were the number of marked positive and negative annotations and the amount of text entered. Topics and specificity of the annotations were coded and analyzed qualitatively. Students annotated on average more negative than positive events. Additional peer-feedback was more often positive. Topics most often related to structuring the consultation. Students were most critical about their biomedical topics. Negative annotations were more specific than positive annotations. Self-evaluations were more specific than peer-feedback and both show a significant correlation. Four response patterns were detected that negatively bias specificity assessment ratings. Teaching students to be more specific in their self-evaluations may be effective for receiving more specific peer-feedback. Videofragmentrating is a convenient tool to implement reflective practice activities like self-evaluation and peer-feedback to the classroom in the teaching of clinical skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Physician Brain Drain from Sub-Saharan Africa: Exploring the Utility of an Eco-psychopolitical Validity Framework for Medical Migration Research

    Directory of Open Access Journals (Sweden)

    Benjamin Siankam

    2011-11-01

    Full Text Available In-depth understanding of any critical social issue requires investigators to use analytical tools that reflect the complexity of the social issue of interest. Toward this aim, I examine the medical brain drain from Sub-Saharan Africa to the United States through the lens of the eco-psychopolitical validity model (see, Christen and Perkins, 2008; Prilleltensky, 2008, an integrative approach that stresses the combined influences of structural factors, individual agency, and power at play in human dynamics and social systems. By adapting the eco-psychopolitical validity model to the study of medical skilled migration, I construe migration as a liberating venture articulated around the triadic process of oppression, empowerment, and wellness. If migrants yearn to breathe free, then émigré physicians are essentially in pursuit of liberation and wellbeing. However, in a world of profound health disparities, where the increasing emigration of medical doctors from resource-constrained countries ultimately leads to loss of lives in the communities left behind, migrant doctors´ individual agency and the multilevel contexts that enable or constrain them to emigrate require critical reflection. Some emerging themes and variations of an ongoing qualitative study are examined using the eco-psychopolitical validity paradigm.

  13. Technological Dynamics and Social Capability

    DEFF Research Database (Denmark)

    Fagerberg, Jan; Feldman, Maryann; Srholec, Martin

    2014-01-01

    for the sample as a whole between 1998 and 2008. The results indicate that social capabilities, such as well-developed public knowledge infrastructure, an egalitarian distribution of income, a participatory democracy and prevalence of public safety condition the growth of technological capabilities. Possible...

  14. A business analytics capability framework

    Directory of Open Access Journals (Sweden)

    Ranko Cosic

    2015-09-01

    Full Text Available Business analytics (BA capabilities can potentially provide value and lead to better organisational performance. This paper develops a holistic, theoretically-grounded and practically relevant business analytics capability framework (BACF that specifies, defines and ranks the capabilities that constitute an organisational BA initiative. The BACF was developed in two phases. First, an a priori conceptual framework was developed based on the Resource-Based View theory of the firm and a thematic content analysis of the BA literature. Second, the conceptual framework was further developed and refined using a three round Delphi study involving 16 BA experts. Changes from the Delphi study resulted in a refined and confirmed framework including detailed capability definitions, together with a ranking of the capabilities based on importance. The BACF will help academic researchers and industry practitioners to better understand the capabilities that constitute an organisational BA initiative and their relative importance. In future work, the capabilities in the BACF will be operationalised to measure their as-is status, thus enabling organisations to identify key areas of strength and weakness and prioritise future capability improvement efforts.

  15. Identifying 21st Century Capabilities

    Science.gov (United States)

    Stevens, Robert

    2012-01-01

    What are the capabilities necessary to meet 21st century challenges? Much of the literature on 21st century skills focuses on skills necessary to meet those challenges associated with future work in a globalised world. The result is a limited characterisation of those capabilities necessary to address 21st century social, health and particularly…

  16. Developing Collaborative Product Development Capabilities

    DEFF Research Database (Denmark)

    Mahnke, Volker; Tran, Yen

    2012-01-01

    innovation strategies’. Our analyses suggest that developing such collaboration capabilities benefits from the search for complementary practices, the combination of learning styles, and the development of weak and strong ties. Results also underscore the crucial importance of co-evolution of multi......Collaborative product development capabilities support a company’s product innovation activities. In the context of the fast fashion sector, this paper examines the development of the product development capabilities (PDC) that align product development capabilities in a dual innovation context......, one, slow paced, where the firm is well established and the other, fast paced, which represents a new competitive arena in which the company competes. To understand the process associated with collaborative capability development, we studied three Scandinavian fashion companies pursuing ‘dual...

  17. Marketing Capability in Strategy Research

    DEFF Research Database (Denmark)

    Ritter, Thomas; Distel, Andreas Philipp

    Following the call for a demand-side perspective of strategic management (e.g., Priem et al., 2012), a firm’s marketing capability, i.e. its ability to interact with down-stream stakeholders, becomes a pivotal element in explaining a firm’s competitiveness. While marketing capability is recognized...... in the strategic management literature as an important driver of firm performance, our review of 86 articles reveals a lack of a generally accepted definition of marketing capability, a lack of a common conceptualization as well as differences in the measurement of marketing capability. In order to build a common...... ground for advancing marketing capability research and thus supporting the demand-side perspective in strategic management, we develop an integrative framework to explain the differences and propose a research agenda for developing the field....

  18. Work system innovation: Designing improvement methods for generative capability

    DEFF Research Database (Denmark)

    Hansen, David; Møller, Niels

    2013-01-01

    This paper explores how a work system’s capability for improvement is influenced by its improvement methods. Based on explorative case study at a Lean manufacturing facility, the methods problem solving and Appreciative Inquiry were compared through in-depth qualitative studies over a 12-month...

  19. Firm Performance and Alliance Capability: The mediating role of culture

    NARCIS (Netherlands)

    de Man, A.P.; Luvison, D.

    2015-01-01

    Purpose – Extant literature has looked at the effect of alliance capability and organizational culture on alliance portfolio performance, but the relationship between the two has not been explored. The purpose of this paper is to explore the hypothesis that an alliance supportive culture is not only

  20. Capabilities and Incapabilities of the Capabilities Approach to Health Justice.

    Science.gov (United States)

    Selgelid, Michael J

    2016-01-01

    This first part of this article critiques Sridhar Venkatapuram's conception of health as a capability. It argues that Venkatapuram relies on the problematic concept of dignity, implies that those who are unhealthy lack lives worthy of dignity (which seems politically incorrect), sets a low bar for health, appeals to metaphysically problematic thresholds, fails to draw clear connections between appealed-to capabilities and health, and downplays the importance/relevance of health functioning. It concludes by questioning whether justice entitlements should pertain to the capability for health versus health achievements, challenging Venkatapuram's claims about the strength of health entitlements, and demonstrating that the capabilities approach is unnecessary to address social determinants of health. © 2016 John Wiley & Sons Ltd.

  1. Medical Rituals and Media Rituals

    OpenAIRE

    Zoltán Zsinkó-Szabó

    2013-01-01

    In the present article the author examines the ritual elements of theprofessionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (withmedical expertise frequently...

  2. Faculty Development for Medical School Community-Based Faculty: A Council of Academic Family Medicine Educational Research Alliance Study Exploring Institutional Requirements and Challenges.

    Science.gov (United States)

    Drowos, Joanna; Baker, Suzanne; Harrison, Suzanne Leonard; Minor, Suzanne; Chessman, Alexander W; Baker, Dennis

    2017-08-01

    Community-based faculty play a large role in training medical students nationwide and require faculty development. The authors hypothesized that positive relationships exist between clerkships paying preceptors and requiring faculty development, and between protected clerkship directors' time and delivering face-to-face preceptor training, as well as with the number or length of community-based preceptor visits. Through under standing the quantity, delivery methods, barriers, and institutional support for faculty development provided to community-based preceptors teaching in family medicine clerkships, best practices can be developed. Data from the 2015 Council of Academic Family Medicine's Educational Research Alliance survey of Family Medicine Clerkship Directors were analyzed. The cross-sectional survey of clerkship directors is distributed annually to institutional representatives of U.S. and Canadian accredited medical schools. Survey questions focused on the requirements, delivery methods, barriers, and institutional support available for providing faculty development to community-based preceptors. Paying community-based preceptors was positively correlated with requiring faculty development in family medicine clerkships. The greatest barrier to providing faculty development was community-based preceptor time availability; however, face-to-face methods remain the most common delivery strategy. Many family medicine clerkship directors perform informal or no needs assessment in developing faculty development topics for community-based faculty. Providing payment to community preceptors may allow schools to enhance faculty development program activities and effectiveness. Medical schools could benefit from constructing a formal curriculum for faculty development, including formal preceptor needs assessment and program evaluation. Clerkship directors may consider recruiting and retaining community-based faculty by employing innovative faculty development delivery

  3. Training Tomorrow's Doctors to Safeguard the Patients of Today: Using Medical Student Simulation Training to Explore Barriers to Recognition of Elder Abuse.

    Science.gov (United States)

    Fisher, James M; Rudd, Matthew P; Walker, Richard W; Stewart, Jane

    2016-01-01

    In recognition of the fact that elder abuse is a global problem that doctors underrecognize and underreport, a simulation training session for undergraduate medical students was developed. The primary objective of this qualitative study was to examine barriers to and drivers of medical students making a diagnosis of elder abuse in simulated practice, with the goal of refining teaching methods and informing future teaching sessions for other clinical teachers. Third-year medical students (Newcastle University, United Kingdom) undertook a simulation scenario with a high-fidelity mannequin representing an elder abuse victim. After the simulation scenario, students underwent a semistructured debriefing. A tripartite approach to data collection was employed that included audio recordings of the simulation, data sheets capturing students' thoughts during the scenario, and postscenario debriefing. A different researcher analyzed each data set in isolation before discussions were held to triangulate findings from the data sets. Forty-six students undertook the scenario; none declined to participate. A number of barriers to students diagnosing elder abuse were identified. Students held a low index of suspicion for elder abuse and were overly optimistic regarding the etiology of the individual's injuries. Students lacked the confidence to raise concerns about possible elder abuse, believing that certainty was required before doing so. There was widespread confusion about nomenclature. These findings provide clinical teachers with important topic areas to address in future teaching sessions. Simulation, as a method to teach about elder abuse in a reproducible and immersive fashion, is recommended to clinical teachers. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  4. Exploring the enablers and barriers to implementing the Medication Appropriateness Tool for Comorbid Health conditions during Dementia (MATCH-D) criteria in Australia: a qualitative study.

    Science.gov (United States)

    Page, Amy Theresa; Clifford, Rhonda Marise; Potter, Kathleen; Seubert, Liza; McLachlan, Andrew J; Hill, Xaysja; King, Stephanie; Clark, Vaughan; Ryan, Cristin; Parekh, Nikesh; Etherton-Beer, Christopher D

    2017-08-23

    The Medication Appropriateness Tool for Comorbid Health conditions in Dementia (MATCH-D) criteria provide expert consensus guidance about medication use for people with dementia. This study aimed to identify enablers and barriers to implementing the criteria in practice. Participants came from both rural and metropolitan communities in two Australian states. Focus groups were held with consumers, general practitioners, nurses and pharmacists. data were analysed thematically. Nine focus groups were conducted. Fifty-five participants validated the content of MATCH-D, appraising them as providing patient-centred principles of care. Participants identified potential applications (including the use of MATCH-D as a discussion aid or educational tool for consumers about medicines) and suggested supporting resources. Participants provided insights into applying MATCH-D in practice and suggested resources to be included in an accompanying toolkit. These data provide external validation of MATCH-D and an empiric basis for their translation to practice. Following resource development, we plan to evaluate the feasibility and efficacy of implementation in practice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Indigenous Technological Innovation : Capability and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Indigenous Technological Innovation : Capability and Competitiveness in China's ... IDRC and key partners will showcase critical work on adaptation and ... Call for new OWSD Fellowships for Early Career Women Scientists now open.

  6. Earth Science Capability Demonstration Project

    Science.gov (United States)

    Cobleigh, Brent

    2006-01-01

    A viewgraph presentation reviewing the Earth Science Capability Demonstration Project is shown. The contents include: 1) ESCD Project; 2) Available Flight Assets; 3) Ikhana Procurement; 4) GCS Layout; 5) Baseline Predator B Architecture; 6) Ikhana Architecture; 7) UAV Capability Assessment; 8) The Big Picture; 9) NASA/NOAA UAV Demo (5/05 to 9/05); 10) NASA/USFS Western States Fire Mission (8/06); and 11) Suborbital Telepresence.

  7. Exploring the importance of different items as reasons for leaving emergency medical services between fully compensated, partially compensated, and non-compensated/volunteer samples.

    Science.gov (United States)

    Blau, Gary; Chapman, Susan; Gibson, Gregory; Bentley, Melissa A

    2011-01-01

    The purpose of our study was to investigate the importance of different items as reasons for leaving the Emergency Medical Service (EMS) profession. An exit survey was returned by three distinct EMS samples: 127 full compensated, 45 partially compensated and 72 non-compensated/volunteer respondents, who rated the importance of 17 different items for affecting their decision to leave EMS. Unfortunately, there were a high percentage of "not applicable" responses for 10 items. We focused on those seven items that had a majority of useable responses across the three samples. Results showed that the desire for better pay and benefits was a more important reason for leaving EMS for the partially compensated versus fully compensated respondents. Perceived lack of advancement opportunity was a more important reason for leaving for the partially compensated and volunteer groups versus the fully compensated group. Study limitations are discussed and suggestions for future research offered.

  8. Exploring topical anti-glaucoma medication effects on the ocular surface in the context of the current understanding of dry eye.

    Science.gov (United States)

    Wong, Aaron B C; Wang, Michael T M; Liu, Kevin; Prime, Zak J; Danesh-Meyer, Helen V; Craig, Jennifer P

    2018-07-01

    To assess tear film parameters, ocular surface characteristics, and dry eye symptomology in patients receiving topical anti-glaucoma medications. Thirty-three patients with a diagnosis of open angle glaucoma or ocular hypertension, receiving unilateral topical anti-glaucoma medication for at least 6 months, were recruited in a cross-sectional, investigator-masked, paired-eye comparison study. Tear film parameters, ocular surface characteristics, and dry eye symptomology of treated and fellow eyes were evaluated and compared. The mean ± SD age of the participants was 67 ± 12 years, and the mean ± SD treatment duration was 5.3 ± 4.4 years. Treated eyes had poorer non-invasive tear film breakup time (p = 0.03), tear film osmolarity (p = 0.04), bulbar conjunctival hyperaemia (p = 0.04), eyelid margin abnormality grade (p = 0.01), tear meniscus height (p = 0.03), and anaesthetised Schirmer value (p = 0.04) than fellow eyes. There were no significant differences in dry eye symptomology, meibomian gland assessments, and ocular surface staining between treated and fellow eyes (all p > 0.05). Adverse changes in tear film stability, tear osmolarity, conjunctival hyperaemia, and eyelid margins were observed in treated eyes. This suggests that inflammatory mechanisms may be implicated in the development of dry eye in patients receiving long term topical anti-glaucoma therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. The Greater Sekhukhune-CAPABILITY outreach project.

    Science.gov (United States)

    Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

    2013-07-01

    The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

  10. Exploration: A misunderstood business

    International Nuclear Information System (INIS)

    Lohrenz, J.

    1991-01-01

    The business of exploration is persistently misunderstand. Why? Misunderstandings persist and even pervade educated, sophisticated, and obviously capable business practitioners and savants of an array of disciplines - finance, economics, and the management sciences. Routine and appropriate assumptions that apply for most businesses invoke nonsense applied to exploration, a unique business. The uniqueness of exploration, unrecognized, sustains the misunderstandings. The authors will not here obliterate these obdurate misunderstandings with some revelation. They show, however, how the misunderstandings naturally arise among those who certainly are not used to being naive

  11. Exploring Integration in Action: Competencies as Building Blocks of Expertise.

    Science.gov (United States)

    Mylopoulos, Maria; Borschel, Debaroti Tina; O'Brien, Tara; Martimianakis, Sofia; Woods, Nicole N

    2017-12-01

    Competency frameworks such as the CanMEDS roles and the ACGME core competencies may lead to the implicit assumption that physicians can learn and practice individual competencies in isolation. In contrast, models of adaptive expertise suggest that the integration of competencies reflects the capabilities of an expert physician. Thus, educational programming aimed at teaching discrete roles or competencies might overlook expert physician capabilities that are central to patient care. To develop expertise, learning opportunities must reflect expert capabilities. To better understand the relationship between competency-based medical education and expert development, the authors sought to explore how integrated competencies are enacted during patient care by postgraduate medical trainees. Using a cognitive ethnographic approach, in 2014-2015 the authors conducted observations and-to refine and elaborate these observations-ad hoc informal interviews with 13 postgraduate trainee participants. Data collection resulted in 92 hours of observation, 26 patient case portraits, and a total of 220 pages of field notes for analysis. Through analysis, the authors identified and examined moments when postgraduate trainees appeared to be simultaneously enacting multiple competencies. The authors identified two key expert capabilities in moments of integrated competence: finding complexity and being patient-centered. They described two mechanisms for these forms of integration: valuing the patient's narrative of their illness, and integrated understanding. Understanding integrated competencies as the building blocks of expert capabilities, along with recognizing the importance of mechanisms that support integration, offers an opportunity to use existing competency-based frameworks to understand and teach adaptive expertise.

  12. Accelerator and Electrodynamics Capability Review

    International Nuclear Information System (INIS)

    Jones, Kevin W.

    2010-01-01

    Los Alamos National Laboratory (LANL) uses capability reviews to assess the science, technology and engineering (STE) quality and institutional integration and to advise Laboratory Management on the current and future health of the STE. Capability reviews address the STE integration that LANL uses to meet mission requirements. The Capability Review Committees serve a dual role of providing assessment of the Laboratory's technical contributions and integration towards its missions and providing advice to Laboratory Management. The assessments and advice are documented in reports prepared by the Capability Review Committees that are delivered to the Director and to the Principal Associate Director for Science, Technology and Engineering (PADSTE). Laboratory Management will use this report for STE assessment and planning. LANL has defined fifteen STE capabilities. Electrodynamics and Accelerators is one of the seven STE capabilities that LANL Management (Director, PADSTE, technical Associate Directors) has identified for review in Fiscal Year (FY) 2010. Accelerators and electrodynamics at LANL comprise a blend of large-scale facilities and innovative small-scale research with a growing focus on national security applications. This review is organized into five topical areas: (1) Free Electron Lasers; (2) Linear Accelerator Science and Technology; (3) Advanced Electromagnetics; (4) Next Generation Accelerator Concepts; and (5) National Security Accelerator Applications. The focus is on innovative technology with an emphasis on applications relevant to Laboratory mission. The role of Laboratory Directed Research and Development (LDRD) in support of accelerators/electrodynamics will be discussed. The review provides an opportunity for interaction with early career staff. Program sponsors and customers will provide their input on the value of the accelerator and electrodynamics capability to the Laboratory mission.

  13. Accelerator and electrodynamics capability review

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Kevin W [Los Alamos National Laboratory

    2010-01-01

    Los Alamos National Laboratory (LANL) uses capability reviews to assess the science, technology and engineering (STE) quality and institutional integration and to advise Laboratory Management on the current and future health of the STE. Capability reviews address the STE integration that LANL uses to meet mission requirements. The Capability Review Committees serve a dual role of providing assessment of the Laboratory's technical contributions and integration towards its missions and providing advice to Laboratory Management. The assessments and advice are documented in reports prepared by the Capability Review Committees that are delivered to the Director and to the Principal Associate Director for Science, Technology and Engineering (PADSTE). Laboratory Management will use this report for STE assessment and planning. LANL has defined fifteen STE capabilities. Electrodynamics and Accelerators is one of the seven STE capabilities that LANL Management (Director, PADSTE, technical Associate Directors) has identified for review in Fiscal Year (FY) 2010. Accelerators and electrodynamics at LANL comprise a blend of large-scale facilities and innovative small-scale research with a growing focus on national security applications. This review is organized into five topical areas: (1) Free Electron Lasers; (2) Linear Accelerator Science and Technology; (3) Advanced Electromagnetics; (4) Next Generation Accelerator Concepts; and (5) National Security Accelerator Applications. The focus is on innovative technology with an emphasis on applications relevant to Laboratory mission. The role of Laboratory Directed Research and Development (LDRD) in support of accelerators/electrodynamics will be discussed. The review provides an opportunity for interaction with early career staff. Program sponsors and customers will provide their input on the value of the accelerator and electrodynamics capability to the Laboratory mission.

  14. International students' experience of a western medical school: a mixed methods study exploring the early years in the context of cultural and social adjustment compared to students from the host country.

    Science.gov (United States)

    McGarvey, A; Brugha, R; Conroy, R M; Clarke, E; Byrne, E

    2015-07-02

    Few studies have addressed the challenges associated with international students as they adapt to studying medicine in a new host country. Higher level institutions have increasing numbers of international students commencing programmes. This paper explores the experiences of a cohort of students in the early years of medical school in Ireland, where a considerable cohort are from an international background. A mixed exploratory sequential study design was carried out with medical students in the preclinical component of a five year undergraduate programme. Data for the qualitative phase was collected through 29 semi-structured interviews using the peer interview method. Thematic analysis from this phase was incorporated to develop an online questionnaire combined with components of the Student Adaptation to College Questionnaire and Student Integration Questionnaire. First year students were anonymously surveyed online. The Mokken Scaling procedure was used to investigate the students' experiences, both positive and negative. Three main themes are identified; social adjustment, social alienation and cultural alienation. The response rate for the survey was 49% (467 Respondents). The Mokken Scaling method identified the following scales (i) Positive experience of student life; (ii) Social alienation, which comprised of negative items about feeling lonely, not fitting in, being homesick and (iii) Cultural alienation, which included the items of being uncomfortable around cultural norms of dress and contact between the sexes. With the threshold set to H = 0.4. Subscales of the positive experiences of student life scale are explored further. Overall student adjustment to a western third level college was good. Students from regions where cultural distance is greatest reported more difficulties in adjusting. Students from these regions also demonstrate very good adaptation. Some students from the host country and more similar cultural backgrounds were also

  15. International exploration by independent

    International Nuclear Information System (INIS)

    Bertragne, R.G.

    1992-01-01

    Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. Foreign finding costs per barrel usually are accepted to be substantially lower than domestic costs because of the large reserve potential of international plays. To get involved in overseas exploration, however, requires the explorationist to adapt to different cultural, financial, legal, operational, and political conditions. Generally, foreign exploration proceeds at a slower pace than domestic exploration because concessions are granted by a country's government, or are explored in partnership with a national oil company. First, the explorationist must prepare a mid- to long-term strategy, tailored to the goals and the financial capabilities of the company; next, is an ongoing evaluation of quality prospects in various sedimentary basins, and careful planning and conduct of the operations. To successfully explore overseas also requires the presence of a minimum number of explorationists and engineers thoroughly familiar with the various exploratory and operational aspects of foreign work. Ideally, these team members will have had a considerable amount of on-site experience in various countries and climates. Independents best suited for foreign expansion are those who have been financially successful in domestic exploration. When properly approached, foreign exploration is well within the reach of smaller U.S. independents, and presents essentially no greater risk than domestic exploration; however, the reward can be much larger and can catapult the company into the 'big leagues.'

  16. Exploring the Knowledge and Perception of Generic Medicines among Final Year Undergraduate Medical, Pharmacy, and Nursing Students in Sierra Leone: A Comparative Cross-Sectional Approach

    Directory of Open Access Journals (Sweden)

    Peter Bai James

    2018-01-01

    Full Text Available Most low-income nations have national medicine policy that emphasized the use of generic medicines in the public health sector. However, the use of generics is often debatable as there are concerns over its efficacy, quality, and safety compared to their branded counterparts. This study was conducted to compare the knowledge and perception of generic medicines among final year undergraduate medical, pharmacy, and nursing students in Sierra Leone. We conducted a questionnaire-based cross-sectional study among these students at the College of Medicine and Allied Health Sciences University of Sierra Leone. Out of the 62 students, only two (2/62, 3.2% knew about the acceptable bioequivalence limit. At least half of respondents in all three groups agreed that all generics are therapeutically equivalent to their innovator brand. At least half of the medicine (21/42, 50% and nursing (6/9, 66.6% students, compared to pharmacy students (5/11, 45.5%, believed that higher safety standards are required for proprietary medicines than for generic medicines. Most of them agreed that they need more information on the safety, quality, and efficacy aspects of generics (59/62, 95.2%. All three groups of healthcare students, despite variations in their responses, demonstrated a deficiency in knowledge and misconception regarding generic medicines. Training on issues surrounding generic drugs in healthcare training institutions is highly needed among future healthcare providers in Sierra Leone.

  17. Minors' rights in medical decision making.

    Science.gov (United States)

    Hickey, Kathryn

    2007-01-01

    In the past, minors were not considered legally capable of making medical decisions and were viewed as incompetent because of their age. The authority to consent or refuse treatment for a minor remained with a parent or guardian. This parental authority was derived from the constitutional right to privacy regarding family matters, common law rule, and a general presumption that parents or guardians will act in the best interest of their incompetent child. However, over the years, the courts have gradually recognized that children younger than 18 years who show maturity and competence deserve a voice in determining their course of medical treatment. This article will explore the rights and interests of minors, parents, and the state in medical decision making and will address implications for nursing administrators and leaders.

  18. Uranium exploration in Ecuador

    International Nuclear Information System (INIS)

    Severne, B.; Penaherrera, P.F.; Fiallos, V.S.

    1981-01-01

    The 600-km segment of the Andean Cordillera in Ecuador includes zones that can be correlated, geologically, with uranium districts elsewhere in the Andes. It is believed that these essentially unexplored zones have the potential for economic uranium mineralization. Exploration activity to date has been limited, although it has involved both geochemical and radiometric techniques to evaluate geological concepts. Minor uranium occurrences (with chemical analyses up to 100 ppm) have been encountered, which provide further incentive to commence large-scale systematic exploration. It is recognized that a very large exploration budget and considerable technical expertise will be required to ensure exploration success. Consequently, participation by groups of proven capability from other countries will be sought for Ecuador's national exploration programme. (author)

  19. Technological Capability and Firm Performance

    Directory of Open Access Journals (Sweden)

    Fernanda Maciel Reichert

    2014-08-01

    Full Text Available This research aims to investigate the relationship between investments in technological capability and economic performance in Brazilian firms. Based on economic development theory and on developed countries history, it is assumed that this relationship is positive. Through key indicators, 133 Brazilian firms have been analyzed. Given the economic circumstances of an emerging economy, which the majority of businesses are primarily based on low and medium-low-technology industries, it is not possible to affirm the existence of a positive relation between technological capability and firm performance. There are other elements that allow firms to achieve such results. Firms of lower technological intensity industries performed above average in the economic performance indicators, adversely, they invested below average in technological capability. These findings do not diminish the merit of firms’ and country’s success. They in fact confirm a historical tradition of a country that concentrates its efforts on basic industries.

  20. Functional capability of piping systems

    International Nuclear Information System (INIS)

    Terao, D.; Rodabaugh, E.C.

    1992-11-01

    General Design Criterion I of Appendix A to Part 50 of Title 10 of the Code of Federal Regulations requires, in part, that structures, systems, and components important to safety be designed to withstand the effects of earthquakes without a loss of capability to perform their safety function. ne function of a piping system is to convey fluids from one location to another. The functional capability of a piping system might be lost if, for example, the cross-sectional flow area of the pipe were deformed to such an extent that the required flow through the pipe would be restricted. The objective of this report is to examine the present rules in the American Society of Mechanical Engineers Boiler and Pressure Vessel Code, Section III, and potential changes to these rules, to determine if they are adequate for ensuring the functional capability of safety-related piping systems in nuclear power plants

  1. Upgrading of TREAT experimental capabilities

    International Nuclear Information System (INIS)

    Dickerman, C.E.; Rose, D.; Bhattacharyya, S.K.

    1982-01-01

    The TREAT facility at the Argonne National Laboratory site in the Idaho National Engineering Laboratory is being upgraded to provide capabilities for fast-reactor-safety transient experiments not possible at any other experimental facility. Principal TREAT Upgrade (TU) goal is provision for 37-pin size experiments on energetics of core-disruptive accidents (CDA) in fast breeder reactor cores with moderate sodium void coefficients. this goal requires a significant enhancement of the capabilities of the TREAT facility, specifically including reactor control, hardened neutron spectrum incident on the test sample, and enlarged building. The upgraded facility will retain the capability for small-size experiments of the types currently being performed in TREAT. Reactor building and crane upgrading have been completed. TU schedules call for the components of the upgraded reactor system to be finished in 1984, including upgraded TREAT fuel and control system, and expanded coverage by the hodoscope fuel-motion diagnostics system

  2. Choosing a New Telephone System for Your Medical Practice.

    Science.gov (United States)

    Metherell, Brian

    2016-01-01

    E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

  3. Nanofabrication principles, capabilities and limits

    CERN Document Server

    Cui, Zheng

    2017-01-01

    This second edition of Nanofabrication is one of the most comprehensive introductions on nanofabrication technologies and processes. A practical guide and reference, this book introduces readers to all of the developed technologies that are capable of making structures below 100nm. The principle of each technology is introduced and illustrated with minimum mathematics involved. Also analyzed are the capabilities of each technology in making sub-100nm structures, and the limits of preventing a technology from going further down the dimensional scale. This book provides readers with a toolkit that will help with any of their nanofabrication challenges.

  4. Is it all about the money? A qualitative exploration of the effects of performance-based financial incentives on Zimbabwe's voluntary male medical circumcision program.

    Directory of Open Access Journals (Sweden)

    Caryl Feldacker

    Full Text Available In 2013, Zimbabwe's voluntary medical male circumcision (VMMC program adopted performance-based financing (PBF to speed progress towards ambitious VMMC targets. The $25 USD PBF intended to encourage low-paid healthcare workers to remain in the public sector and to strengthen the public healthcare system. The majority of the incentive supports healthcare workers (HCWs who perform VMMC alongside other routine services; a small portion supports province, district, and facility levels.This qualitative study assessed the effect of the PBF on HCW motivation, satisfaction, and professional relationships. The study objectives were to: 1 Gain understanding of the advantages and disadvantages of PBF at the HCW level; 2 Gain understanding of the advantages and disadvantages of PBF at the site level; and 3 Inform scale up, modification, or discontinuation of PBF for the national VMMC program. Sixteen focus groups were conducted: eight with HCWs who received PBF for VMMC and eight with HCWs in the same clinics who did not work in VMMC and, therefore, did not receive PBF. Fourteen key informant interviews ascertained administrator opinion.Findings suggest that PBF appreciably increased motivation among VMMC teams and helped improve facilities where VMMC services are provided. However, PBF appears to contribute to antagonism at the workplace, creating divisiveness that may reach beyond VMMC. PBF may also cause distortion in the healthcare system: HCWs prioritized incentivized VMMC services over other routine duties. To reduce workplace tension and improve the VMMC program, participants suggested increasing HCW training in VMMC to expand PBF beneficiaries and strengthening integration of VMMC services into routine care.In the low-resource, short-staffed context of Zimbabwe, PBF enabled rapid VMMC scale up and achievement of ambitious targets; however, side effects make PBF less advantageous and sustainable than envisioned. Careful consideration is warranted in

  5. Deployment of vendor capabilities and competences throughout the outsourcing process

    DEFF Research Database (Denmark)

    Perunovic, Zoran; Christoffersen, Mads; Mefford, Robert N.

    2012-01-01

    Purpose - A vendor's capabilities are recognized as one of the most important factors for success in outsourcing. However, there is a lack of understanding of how vendors manage their capabilities throughout the outsourcing process. With an aim to contribute to filling this existing gap......, the purpose of this paper is to explore how vendors deploy their capabilities in order to win, run and renew the outsourcing contracts. Design/methodology/approach - The research question has been derived by integrating a resource-based view theory with a model of a vendor's process in outsourcing. A multiple......-case study of three contract electronic manufacturers has been employed to explore the research question. Findings - The results show that for achieving their outsourcing objectives, vendors use different capability mixes: the winning, the running, and the renewing. These mixes are created through...

  6. Building server capabilities in China

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi; Slepniov, Dmitrij; Wæhrens, Brian Vejrum

    2012-01-01

    The purpose of this paper is to further our understanding of multinational companies building server capabilities in China. The paper is based on the cases of two western companies with operations in China. The findings highlight a number of common patterns in the 1) managerial challenges related...

  7. Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Teppo; Foss, Nicolai Juul; Heimriks, Koen H.

    We discuss the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories of micro-level components underlying routines...

  8. Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Tippo; Foss, Nicolai Juul; Heimericks, Koen H.

    2012-01-01

    This article introduces the Special Issue and discusses the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories ...

  9. Capability and Learning to Choose

    Science.gov (United States)

    LeBmann, Ortrud

    2009-01-01

    The Capability Approach (henceforth CA) is in the first place an approach to the evaluation of individual well-being and social welfare. Many disciplines refer to the CA, first and foremost welfare economics, development studies and political philosophy. Educational theory was not among the first disciplines that took notice of the CA, but has a…

  10. Research for new UAV capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Canavan, G.H.; Leadabrand, R.

    1996-07-01

    This paper discusses research for new Unmanned Aerial Vehicles (UAV) capabilities. Findings indicate that UAV performance could be greatly enhanced by modest research. Improved sensors and communications enhance near term cost effectiveness. Improved engines, platforms, and stealth improve long term effectiveness.

  11. Development of students learning capabilities and professional capabilities

    DEFF Research Database (Denmark)

    Ringtved, Ulla Lunde; Wahl, Christian; Belle, Gianna

    This paper describes the work-in-progress on a project that aims todevelop a tool that via learning analytic methods enable studentsto enhance, document and assess the development of their learningcapabilities and professional capabilities in consequence of theirself-initiated study activities...... during their bachelor educations. Thetool aims at enhancing the development of students’ capabilities toself-initiate, self-regulate and self-assess their study activities.The tool uses the concept of collective intelligence as source formotivation and inspiration in self-initiating study activities...... as wellas self-assessing them. The tool is based on a heutagogical approachto support reflection on learning potential in these activities. Thisenhances the educational use of students self-initiated learningactivities by bringing visibility and evidence to them, and therebybringing value to the assessment...

  12. The Interface of IT Capabilities and Disruptive Innovations

    DEFF Research Database (Denmark)

    Baiyere, Abayomi

    2017-01-01

    The occurrence of disruptive innovations tends to challenge the fabric, structure and capability that define firms facing their threat. Prior research indicates that the capacity of a firm to restructure and reconfigure its resources to face/leverage such turbulent situations is dependent on how...... well it can orchestrate its capabilities. Although IT capability has been identified as one of the essential capability of today’s organisations, managers as well as researchers are yet to uncover the dynamics through which an organisation’s IT capability can be leveraged in disruptive innovation...... situations. This paper contributes to our understanding in this direction by conceptually exploring the different roles of an organisation's IT capabilitiy in disruptive innovation scenarios. The paper provides a synthesis of the current state of knowledge about both concepts and extends this to highlight...

  13. Business and IT Capabilities for Cloud Platform Success

    DEFF Research Database (Denmark)

    Hahn, Christopher; Huntgeburth, Jan; Winkler, Till J.

    2016-01-01

    The growing proliferation of cloud platform ecosystems demands a deeper understanding of the capabilities that help existing and emerging platform providers to be successful by creating and appropriating value. This multiple case study of four cloud platform providers (three large, one SME......) instantiates Rai and Tang’s (2014) framework of dyadic IT and network IT capabilities for a cloud platform context and extends it by exploring previously undertheorized cloud platform business capabilities. We further build on this extended framework by employing a configurational perspective to elucidate...... the complementary role of the three proposed business capabilities (incentives and rules, ecosystem marketing and sales, partner development and support) for relevant value creation and appropriation mechanisms. In addition to providing a capability framework catered to the cloud platform context, our findings...

  14. Exploration Review

    Science.gov (United States)

    Wilburn, D.R.; Stanley, K.A.

    2013-01-01

    This summary of international mineral exploration activities for 2012 draws upon information from industry sources, published literature and U.S. Geological Survey (USGS) specialists. The summary provides data on exploration budgets by region and mineral commodity, identifies significant mineral discoveries and areas of mineral exploration, discusses government programs affecting the mineral exploration industry and presents analyses of exploration activities performed by the mineral industry. Three sources of information are reported and analyzed in this annual review of international exploration for 2012: 1) budgetary statistics expressed in U.S. nominal dollars provided by SNL Metals Economics Group (MEG) of Halifax, Nova Scotia; 2) regional and site-specific exploration activities that took place in 2012 as compiled by the USGS and 3) regional events including economic, social and political conditions that affected exploration activities, which were derived from published sources and unpublished discussions with USGS and industry specialists.

  15. Exploration technology

    Energy Technology Data Exchange (ETDEWEB)

    Roennevik, H.C. [Saga Petroleum A/S, Forus (Norway)

    1996-12-31

    The paper evaluates exploration technology. Topics discussed are: Visions; the subsurface challenge; the creative tension; the exploration process; seismic; geology; organic geochemistry; seismic resolution; integration; drilling; value creation. 4 refs., 22 figs.

  16. Repository exploration

    International Nuclear Information System (INIS)

    Pentz, D.L.

    1984-01-01

    This paper discusses exploration objectives and requirements for a nuclear repository in the U.S.A. The importance of designing the exploration program to meet the system performance objectives is emphasized and some examples of the extent of exploration required before the License Application for Construction Authorization is granted are also discussed

  17. Bayesian Analysis for Risk Assessment of Selected Medical Events in Support of the Integrated Medical Model Effort

    Science.gov (United States)

    Gilkey, Kelly M.; Myers, Jerry G.; McRae, Michael P.; Griffin, Elise A.; Kallrui, Aditya S.

    2012-01-01

    The Exploration Medical Capability project is creating a catalog of risk assessments using the Integrated Medical Model (IMM). The IMM is a software-based system intended to assist mission planners in preparing for spaceflight missions by helping them to make informed decisions about medical preparations and supplies needed for combating and treating various medical events using Probabilistic Risk Assessment. The objective is to use statistical analyses to inform the IMM decision tool with estimated probabilities of medical events occurring during an exploration mission. Because data regarding astronaut health are limited, Bayesian statistical analysis is used. Bayesian inference combines prior knowledge, such as data from the general U.S. population, the U.S. Submarine Force, or the analog astronaut population located at the NASA Johnson Space Center, with observed data for the medical condition of interest. The posterior results reflect the best evidence for specific medical events occurring in flight. Bayes theorem provides a formal mechanism for combining available observed data with data from similar studies to support the quantification process. The IMM team performed Bayesian updates on the following medical events: angina, appendicitis, atrial fibrillation, atrial flutter, dental abscess, dental caries, dental periodontal disease, gallstone disease, herpes zoster, renal stones, seizure, and stroke.

  18. Human-Centered Design Capability

    Science.gov (United States)

    Fitts, David J.; Howard, Robert

    2009-01-01

    For NASA, human-centered design (HCD) seeks opportunities to mitigate the challenges of living and working in space in order to enhance human productivity and well-being. Direct design participation during the development stage is difficult, however, during project formulation, a HCD approach can lead to better more cost-effective products. HCD can also help a program enter the development stage with a clear vision for product acquisition. HCD tools for clarifying design intent are listed. To infuse HCD into the spaceflight lifecycle the Space and Life Sciences Directorate developed the Habitability Design Center. The Center has collaborated successfully with program and project design teams and with JSC's Engineering Directorate. This presentation discusses HCD capabilities and depicts the Center's design examples and capabilities.

  19. LOFT Augmented Operator Capability Program

    International Nuclear Information System (INIS)

    Hollenbeck, D.A.; Krantz, E.A.; Hunt, G.L.; Meyer, O.R.

    1980-01-01

    The outline of the LOFT Augmented Operator Capability Program is presented. This program utilizes the LOFT (Loss-of-Fluid Test) reactor facility which is located at the Idaho National Engineering Laboratory and the LOFT operational transient experiment series as a test bed for methods of enhancing the reactor operator's capability for safer operation. The design of an Operational Diagnotics and Display System is presented which was backfit to the existing data acquisition computers. Basic color-graphic displays of the process schematic and trend type are presented. In addition, displays were developed and are presented which represent safety state vector information. A task analysis method was applied to LOFT reactor operating procedures to test its usefulness in defining the operator's information needs and workload

  20. Evolving Capabilities for Virtual Globes

    Science.gov (United States)

    Glennon, A.

    2006-12-01

    Though thin-client spatial visualization software like Google Earth and NASA World Wind enjoy widespread popularity, a common criticism is their general lack of analytical functionality. This concern, however, is rapidly being addressed; standard and advanced geographic information system (GIS) capabilities are being developed for virtual globes--though not centralized into a single implementation or software package. The innovation is mostly originating from the user community. Three such capabilities relevant to the earth science, education, and emergency management communities are modeling dynamic spatial phenomena, real-time data collection and visualization, and multi-input collaborative databases. Modeling dynamic spatial phenomena has been facilitated through joining virtual globe geometry definitions--like KML--to relational databases. Real-time data collection uses short scripts to transform user-contributed data into a format usable by virtual globe software. Similarly, collaborative data collection for virtual globes has become possible by dynamically referencing online, multi-person spreadsheets. Examples of these functions include mapping flows within a karst watershed, real-time disaster assessment and visualization, and a collaborative geyser eruption spatial decision support system. Virtual globe applications will continue to evolve further analytical capabilities, more temporal data handling, and from nano to intergalactic scales. This progression opens education and research avenues in all scientific disciplines.

  1. 新人文主义视野下医学生医德培养探索——医德培养档案构建初探%Exploration of Medical Ethics Education in the Perspective of New Humanism: -on medical ethics education profile building

    Institute of Scientific and Technical Information of China (English)

    陈笑笑

    2011-01-01

    医疗行为的主客体都是有意识的生命个体,这是医学生医德培养的根本出发点.然而当前我国医德培养中出现了"物化"趋势.以白璧德为代表的新人文主义思想批判过分功利性教育,旨在以人文标准来实现教育之塑造真正的人的根本目的.应充分汲取新人文主义思想中的伦理学因素-人格与道德的完善,探索构建医德培养档案的目标、形式、内容、特点和意义,为加强医学生医德伦理教育的实效性,全面提升医学专业人才的人文与科学素养,塑造医学生完善的医德人格提供有效的途径.%The fact that both the subject and the object of medical practice are conscious humanbeings is regarded as the fundamental principle in medical ethics education. However, there has been a materialization tendency in recent Chinese medical ethics education. Irving Babbitt, the representative of the New Humanism criticized the over- utilitarian education at that time in America, aiming at rebuilding humanistic standards and realizing the final goal of education - creating a truly integral man. In the perspective of New Humanism, this study explores the goal, formality, content, feature and importance of building profiles for students' medical ethics education, in order to enhance the effectiveness, promote the quality of humanity and scientific literacy, and provide effective ways for ethical personality perfection of medical students.

  2. INV Market Entry: Legitimation and Capability

    DEFF Research Database (Denmark)

    Turcan, Romeo V.

    and concerns. The author of this paper was hired as CEO in September 2005 by INV-NGO to start-up, grow and lead its branch in an emerging market. The events and incidents occurred between 2005 and 2009. The approach of narrating organization is employed to present, analyze and interpret the data. A number......This paper explores external and internal critical incidents that shape the emergence of new forms and ways of organizing in a new venture that was launched in an emerging market by an international new non-for-profit organization. The paper responds to extant criticism that most of the knowledge...... about the internal organization of firms comes from the research on large established organizations and that the research aimed to understand internal organization of entrepreneurial ventures is scarce. Theoretically the paper is grounded within legitimation and dynamic capability theories of the firm...

  3. An eHealth Capabilities Framework for Graduates and Health Professionals: Mixed-Methods Study.

    Science.gov (United States)

    Brunner, Melissa; McGregor, Deborah; Keep, Melanie; Janssen, Anna; Spallek, Heiko; Quinn, Deleana; Jones, Aaron; Tseris, Emma; Yeung, Wilson; Togher, Leanne; Solman, Annette; Shaw, Tim

    2018-05-15

    The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs. ©Melissa Brunner, Deborah Mc

  4. Improving the Agency's Software Acquisition Capability

    Science.gov (United States)

    Hankinson, Allen

    2003-01-01

    External development of software has oftc n led to unsatisfactory results and great frustration for the assurE 7ce community. Contracts frequently omit critical assuranc 4 processes or the right to oversee software development activitie: At a time when NASA depends more and more on software to in plement critical system functions, combination of three factors ex; cerbate this problem: I ) the ever-increasing trend to acquire rather than develop software in-house, 2) the trend toward performance based contracts, and 3) acquisition vehicles that only state softwar 2 requirements while leaving development standards and assur! ince methodologies up to the contractor. We propose to identify specific methods at d tools that NASA projects can use to mitigate the adverse el ects of the three problems. TWO broad classes of methoddt ols will be explored. The first will be those that provide NASA p ojects with insight and oversight into contractors' activities. The st cond will be those that help projects objectively assess, and thus i nprwe, their software acquisition capability. Of particular interest is the Software Engineering Institute's (SEI) Software Acqt isition Capability Maturity Model (SA-CMMO).

  5. Capability Development in an Offshoring Context

    DEFF Research Database (Denmark)

    Jaura, Manya

    Capability development can be defined as deliberate firm-level investment involving a search and learning process aimed at modifying or enhancing existing capabilities. Increasingly, firms are relocating advanced services to offshore locations resulting in the challenge of capability development ...

  6. Summary of Sandia Laboratories technical capabilities

    International Nuclear Information System (INIS)

    1977-05-01

    The technical capabilities of Sandia Laboratories are detailed in a series of companion reports. In this summary the use of the capabilities in technical programs is outlined and the capabilities are summarized. 25 figures, 3 tables

  7. Production, innovation and service capabilities

    DEFF Research Database (Denmark)

    Slepniov, Dmitrij; Wæhrens, Brian Vejrum; Wu, Dong

    2012-01-01

    crossing both national and organisational borders emerge. The challenge of coordination in these configurations is an imperative which has not been adequately addressed so far. Therefore, by using explorative cases of Chinese and Danish companies, this paper seeks to develop a conceptual framework relating...... functional nodes of global production networks and devising appropriate coordination mechanisms between them....

  8. Organizational Learning Capability: An Example of University Hospital

    Directory of Open Access Journals (Sweden)

    Yasin UZUNTARLA

    2015-06-01

    Full Text Available In health care institutions aiming healthy society by the way protecting and promoting human health, reaching information has a vital importance. This descriptive research purposed an evaluation of organizational learning capability of 396 employees working in Gülhane Military Medical Academy Hospital. A questionnaire including socio-demographic characteristics was used along with Organizational Learning Capability scale designed by Ricardo CHIVA and His Friends. Data acquired was analyzed with SPSS 15.0 program. Participants’ Organizational Learning Capability and its subscales means were assessed in terms of their sociodemographic characteristics. Assessing participants’ answers in terms of 5 subscales which are experimentation, risk taking, interaction with the external environment, dialogue and participatory decision-making; for education level and professional groups, statistical significant differences was found between Organizational Learning Capability and its subscales means.

  9. Developing A/E Capabilities

    International Nuclear Information System (INIS)

    Gonzalez, A.; Gurbindo, J.

    1987-01-01

    During the last few years, the methods used by EMPRESARIOS AGRUPADOS and INITEC to perform Architect-Engineering work in Spain for nuclear projects has undergone a process of significant change in project management and engineering approaches. Specific practical examples of management techniques and design practices which represent a good record of results will be discussed. They are identified as areas of special interest in developing A/E capabilities for nuclear projects . Command of these areas should produce major payoffs in local participation and contribute to achieving real nuclear engineering capabities in the country. (author)

  10. PROGRAMS WITH DATA MINING CAPABILITIES

    Directory of Open Access Journals (Sweden)

    Ciobanu Dumitru

    2012-03-01

    Full Text Available The fact that the Internet has become a commodity in the world has created a framework for anew economy. Traditional businesses migrate to this new environment that offers many features and options atrelatively low prices. However competitiveness is fierce and successful Internet business is tied to rigorous use of allavailable information. The information is often hidden in data and for their retrieval is necessary to use softwarecapable of applying data mining algorithms and techniques. In this paper we want to review some of the programswith data mining capabilities currently available in this area.We also propose some classifications of this softwareto assist those who wish to use such software.

  11. Medical imaging

    CERN Document Server

    Townsend, David W

    1996-01-01

    Since the introduction of the X-ray scanner into radiology almost 25 years ago, non-invasive imaging has become firmly established as an essential tool in the diagnosis of disease. Fully three-dimensional imaging of internal organs is now possible, b and for studies which explore the functional status of the body. Powerful techniques to correlate anatomy and function are available, and scanners which combine anatomical and functional imaging in a single device are under development. Such techniques have been made possible through r ecent technological and mathematical advances. This series of lectures will review both the physical basis of medical imaging techniques using X-rays, gamma and positron emitting radiosiotopes, and nuclear magnetic resonance, and the mathematical methods used to reconstruct three-dimentional distributions from projection data. The lectures will trace the development of medical imaging from simple radiographs to the present-day non-invasive measurement of in vivo biochemistry. They ...

  12. Weaving together peer assessment, audios and medical vignettes in teaching medical terms

    Science.gov (United States)

    Khan, Lateef M.

    2015-01-01

    Objectives The current study aims at exploring the possibility of aligning peer assessment, audiovisuals, and medical case-report extracts (vignettes) in medical terminology teaching. In addition, the study wishes to highlight the effectiveness of audio materials and medical history vignettes in preventing medical students' comprehension, listening, writing, and pronunciation errors. The study also aims at reflecting the medical students' attitudes towards the teaching and learning process. Methods The study involved 161 medical students who received an intensive medical terminology course through audio and medical history extracts. Peer assessment and formative assessment platforms were applied through fake quizzes in a pre- and post-test manner. An 18-item survey was distributed amongst students to investigate their attitudes and feedback towards the teaching and learning process. Quantitative and qualitative data were analysed using the SPSS software. Results The students did better in the posttests than on the pretests for both the quizzes of audios and medical vignettes showing a t-test of -12.09 and -13.60 respectively. Moreover, out of the 133 students, 120 students (90.22%) responded to the survey questions. The students gave positive attitudes towards the application of audios and vignettes in the teaching and learning of medical terminology and towards the learning process. Conclusions The current study revealed that the teaching and learning of medical terminology have more room for the application of advanced technologies, effective assessment platforms, and active learning strategies in higher education. It also highlights that students are capable of carrying more responsibilities of assessment, feedback, and e-learning. PMID:26637986

  13. Capability through Participatory Democracy: Sen, Freire, and Dewey

    Science.gov (United States)

    Glassman, Michael; Patton, Rikki

    2014-01-01

    This paper explores possible important relationships and sympathies between Amartya Sen's Capabilities Approach framework for understanding the human condition and the educational ideas of John Dewey and Paolo Freire. All three focus on the importance of democratic values in a fair, well-functioning society, while Sen and Freire especially…

  14. Deployment of vendor innovation capability in contract electronic manufacturing

    DEFF Research Database (Denmark)

    Perunovic, Zoran; Mefford, Robert N.

    2012-01-01

    This paper explores deployment of innovation capability in outsourcing from the vendor perspective. Vendor’s innovation-related competences are used to capture vendor innovativeness. A multiple-case study was applied with two Contract Electronic Manufacturers. Based on the data analysis we propose...

  15. International exploration by independents

    International Nuclear Information System (INIS)

    Bertagne, R.G.

    1991-01-01

    Recent industry trends indicate that the smaller US independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. It is usually accepted that foreign finding costs per barrel are substantially lower than domestic because of the large reserve potential of international plays. To get involved overseas requires, however, an adaptation to different cultural, financial, legal, operational, and political conditions. Generally foreign exploration proceeds at a slower pace than domestic because concessions are granted by the government, or are explored in partnership with the national oil company. First, a mid- to long-term strategy, tailored to the goals and the financial capabilities of the company, must be prepared; it must be followed by an ongoing evaluation of quality prospects in various sedimentary basins, and a careful planning and conduct of the operations. To successfully explore overseas also requires the presence on the team of a minimum number of explorationists and engineers thoroughly familiar with the various exploratory and operational aspects of foreign work, having had a considerable amount of onsite experience in various geographical and climatic environments. Independents that are best suited for foreign expansion are those that have been financially successful domestically, and have a good discovery track record. When properly approached foreign exploration is well within the reach of smaller US independents and presents essentially no greater risk than domestic exploration; the reward, however, can be much larger and can catapult the company into the big leagues

  16. Detection capabilities. Some historical footnotes

    International Nuclear Information System (INIS)

    Currie, L.A.

    2017-01-01

    Part I Summary of relevant topics from 1923 to present-including: Currie (Anal Chem 40:586-593, 1968) detection concepts and capabilities; International detection and uncertainty standards; Failure of classical "1"4C dating and birth of new scientific disciplines; Exploratory nuclear data analysis of "8"5Kr monitors found coincident with the collapse of the Iron Curtain (1989); Faulty statistics proved responsible for mistaken assertions that Currie's LC yields excessive false positives; Low-level counting and AMS for atmospheric "3"7Ar and µmolar fossil/biomass carbon in the environment; Erroneous assumption that our low-level background is a Poisson Process, linked to ∼8 % spurious anticoincidence events. Part II. Exact treatment of bivariate Poisson data-solved in 1930s by Przyborowski and Wilenski, Krakow University, for detecting extreme trace amounts of a malicious contaminant (dodder) in high purity seed standards. We adapted their treatment to detection capabilities in ultra-low-level nuclear counting. The timing of their work had great historical significance, marking the start of World War II, with the invasion of Poland (1939). (author)

  17. WFPC2 Science Capability Report

    Science.gov (United States)

    Brown, David I.

    2001-01-01

    In the following pages, a brief outline of the salient science features of Wide Field/Planetary Camera 2 (WFPC2) that impact the proposal writing process and conceptual planning of observations is presented. At the time of writing, WFPC2, while having been better defined than in the past, is far from being at the stage where science and engineering details are well enough known that concrete observational/operational sequences can be plannned with assurance. Conceptual issues are another matter. The thrust of the Science Capability Report at this time is to outline the known performance parameters and capabilities of WFPC2, filling in with specifications when necessary to hold a place for these items as they become known. Also, primary scientific and operational differences between WFPC 1 and 2 are discussed section-by-section, along with issues that remain to be determined and idiosyncrasies when known. Clearly the determination of the latter awaits some form of testing, most likely thermal/vacuum testing. All data in this report should be viewed with a jaundiced eye at this time.

  18. Vital Signs Monitoring System Using Radio Frequency Communication: A Medical Care Terminal for Beddridden People Support

    Directory of Open Access Journals (Sweden)

    Fábio FERREIRA

    2015-02-01

    Full Text Available In this paper, the data transmission of an acquisition system for biomedical vital signs via Radio Frequency (RF communication is explored. This system can be considered a medical care terminal (MCT. It was developed a platform capable of recording the patient's physiological signals to check if any medical evolution/change occurred. The system allows also acquiring the environment data, as for example the room temperature and luminosity. The main achievement of this paper is the patients’ real-time health condition monitoring by the medical personnel or caregivers that will contribute to prevent health problems, especially for bedridden people with reduced mobility.

  19. Putting Role 1 first: the Role 1 capability review.

    Science.gov (United States)

    Hodgetts, T J; Findlay, S

    2012-09-01

    To quantify the risk for delivering care at Role 1 in the Land Environment (point of wounding to hospital care) on current operations and set the conditions for systematic change to enhance future capability. UK, US and Danish Army Role 1 Subject Matter Experts (SMEs) (1) Questionnaire study ofUK SMEs to determine capability gaps; (2) Questionnaire study of US and Danish SMEs to benchmark UK capability; (3) Semi-structured interviews of UK SMEs; (4) In-theatre evaluation of deployed Role 1. Thirty two SMEs completed the questionnaire (68% response rate), comprising 25 medical officers (20 in clinical appointments; five in command and staff appointments), six nurses and one medical support officer. Results of the entire review were collated as a cross-Defence Lines of Development analysis, separating the specific experience of 1 Medical Regiment's Hybrid Foundation Training (HFT), Mission Specific Training (MST) and deployment cycle from the analysis gained from questionnaire studies, SME consultation and documentary evidence. The review generated 77 recommendations and 38 sub-recommendations. The top six messages of the review were (1) To balance the expressed desire to increase the ratio of trained Team Medics with the reality of generating credible instructors with clinical experience; (2) To recognise that inadequate experience for Combat Medical Technicians in Primary Healthcare in the Firm Base undermines their operational preparedness; (3) To recognise that Current Regimental Aid Post (RAP) at contingency without power lacks the rudimentary infrastructure of a modern Medical Treatment Facility; (4) To recognise that inappropriate deployment of personnel with chronic disease or acutely limiting conditions is a consistent trend for 20 years that highlights continuing system weaknesses in applying protective medical grading; (5) To accept that General Practitioner manning requires re-evaluating as an Operational Pinch Point, reviewing all options to maintain

  20. Researching pharmacist managerial capability: philosophical perspectives and paradigms of inquiry.

    Science.gov (United States)

    Woods, Phillip; Gapp, Rod; King, Michelle A

    2015-01-01

    In successful community pharmacy business enterprises suitably responsive actions to meet ever-increasing change require capable pharmacy managers who readily learn and adapt. Capability as a concept is generally understood to be the ability of a manager to identify and act to solve unfamiliar problems in unfamiliar situations. Capability is characterized by adaptability and flexibility. However, different understandings of the concept 'capability' and what it means to be 'capable' are indirect and incomplete. This paper aims to clarify current theories regarding the concept of 'capability' at the level of the individual, and through this to make more explicit what is known about the phenomenon, but more particularly, how we know what we know. The analysis includes the concept of 'competence' because explanations of capability include competence, and the two concepts are not clearly separated in the literature. By probing the epistemological origins of current theory concerning both concepts, the limiting taken for granted assumptions are revealed. Assumptions about context and time, and the psychological theory through which individuals are assumed to perceive, know and learn, are illuminated. The analysis, in connection with the literature, shows how the interpretive philosophic research approach may reveal a different and useful theoretical perspective for explaining capability as a dynamic performance. It is suggested that such a perspective may narrow the gap between the theory of capability and its practice. The interpretive perspective holds potential to reveal how capability, as performed by successful community pharmacy managers, might be further researched and strengthened. This paper supports the challenging suggestion that pharmacy social research needs to rebalance the dominance of purely empirical research by exploring interpretive methodologies to better understand human actions and relations in the context of pharmacy. Crown Copyright © 2015

  1. The Muddle of Medicalization

    DEFF Research Database (Denmark)

    Sholl, Jonathan

    2017-01-01

    to describe inappropriate or abusive instances of medical authority. Yet, while this standard approach claims that medicalization is a growing problem, it assumes that there is simply one “medical model” and that the expanding realm of “the medical” can be more or less clearly delineated. Moreover, while...... of medical discourse. In doing so, I will explore the distinction between medicalization and pathologization, a distinction that is often overlooked and that brings with it many conceptual and practical implications. After defining these terms, I will use some examples to show that while pathologizing...

  2. Capabilities, innovation, and overall performance in Brazilian export firms.

    Directory of Open Access Journals (Sweden)

    José Ednilson de Oliveira Cabral

    2015-06-01

    Full Text Available This article extends the current research on innovation by investigating the relationship between innovative capabilities and export firms’ overall performance. From the perspectives of the resource-based view (RBV and dynamic capability, we examine the differential and interactive effects of exploration and exploitation capabilities in product innovation for external markets and overall performance (direct and mediated by a new product. In addition, we test the moderating effect of market dynamism and the controlling effect of firm size on these relationships. Hence, the main contribution of this article is developing and empirically testing an original model, by combining these constructs that address new relationships, in an emerging country. This model was tested with data from 498 Brazilian export firms, distributed throughout all Brazilian manufacturing sectors, by firm size, and in states. The analysis was made with application of the structural equation modeling (SEM. As a result, we found support for the assumptions that exploitation capabilities influence product innovation and overall performance, whereas exploration capabilities and their interaction to exploitation capabilities influence overall performance, but not product innovation. Additionally, the relationship between exploitation capabilities and overall performance is mediated by product innovation. Unlike hypothesized, market dynamism does not moderate the relationship between product innovation and overall performance. Furthermore, firm size works as a controlling variable in the relationships analyzed. Regarding the implications for theory, this study contributes to grasp that exploitation capabilities influences a firm’s overall performance, both directly and indirectly (via product innovation, and highlights the various direct and mediatory effects of innovation on overall performance. These insights show the importance of considering the role of mediating and

  3. MHTGR inherent heat transfer capability

    International Nuclear Information System (INIS)

    Berkoe, J.M.

    1992-01-01

    This paper reports on the Commercial Modular High Temperature Gas-Cooled Reactor (MHTGR) which achieves improved reactor safety performance and reliability by utilizing a completely passive natural convection cooling system called the RCCS to remove decay heat in the event that all active cooling systems fail to operate. For the highly improbable condition that the RCCS were to become non-functional following a reactor depressurization event, the plant would be forced to rely upon its inherent thermo-physical characteristics to reject decay heat to the surrounding earth and ambient environment. A computational heat transfer model was created to simulate such a scenario. Plant component temperature histories were computed over a period of 20 days into the event. The results clearly demonstrate the capability of the MHTGR to maintain core integrity and provide substantial lead time for taking corrective measures

  4. Author's capabilities in author indexing

    International Nuclear Information System (INIS)

    Ooi, Shoichi

    1988-01-01

    The purpose of this paper is to provide a author capability of current author indexing practices in journal literature indexing practices in 'Journal of Nuclear Science and Technology of Japan'. This Journal employed keywords freely assigned by author and not taken from INIS Thesaurus or other vocabulary list. Author examined 413 literatures, comparing keywords assigned by the literatures' authors with descriptor's (ATOMINDEX) assigned by an experienced professional indexer. The results of the comparisons showed that the average set of terms assigned by author included about 70% of all the terms assigned to the same literature by the professional indexer. Authors eventually would contribute, for the most effective point to create reference to information is at the time of its generation. Consequently, it may be possible to transfer them easily to descriptors in every secondary information system. (author)

  5. Organizational Economics of Capability and Heterogeneity

    DEFF Research Database (Denmark)

    Argyres, Nicholas S.; Felin, Teppo; Foss, Nicolai Juul

    2012-01-01

    For decades, the literatures on firm capabilities and organizational economics have been at odds with each other, specifically relative to explaining organizational boundaries and heterogeneity. We briefly trace the history of the relationship between the capabilities literature and organizational...... economics, and we point to the dominance of a “capabilities first” logic in this relationship. We argue that capabilities considerations are inherently intertwined with questions about organizational boundaries and internal organization, and we use this point to respond to the prevalent capabilities first...... logic. We offer an integrative research agenda that focuses first on the governance of capabilities and then on the capability of governance....

  6. International exploration by independents

    International Nuclear Information System (INIS)

    Bertagne, R.G.

    1992-01-01

    Recent industry trends indicate that the smaller U.S. independents are looking at foreign exploration opportunities as one of the alternatives for growth in the new age of exploration. The problems of communications and logistics caused by different cultures and by geographic distances must be carefully evaluated. A mid-term to long-term strategy tailored to the goals and the financial capabilities of the company should be prepared and followed by a careful planning of the operations. This paper addresses some aspects of foreign exploration that should be considered before an independent venture into the foreign field. It also provides some guidelines for conducting successful overseas operations. When properly assessed, foreign exploration is well within the reach of smaller U.S. independents and presents no greater risk than domestic exploration; the rewards, however, can be much larger. Furthermore, the Oil and Gas Journal surveys of the 300 largest U.S. petroleum companies show that companies with a consistent foreign exploration policy have fared better financially during difficult times

  7. OPSAID improvements and capabilities report.

    Energy Technology Data Exchange (ETDEWEB)

    Halbgewachs, Ronald D.; Chavez, Adrian R.

    2011-08-01

    Process Control System (PCS) and Industrial Control System (ICS) security is critical to our national security. But there are a number of technological, economic, and educational impediments to PCS owners implementing effective security on their systems. Sandia National Laboratories has performed the research and development of the OPSAID (Open PCS Security Architecture for Interoperable Design), a project sponsored by the US Department of Energy Office of Electricity Delivery and Energy Reliability (DOE/OE), to address this issue. OPSAID is an open-source architecture for PCS/ICS security that provides a design basis for vendors to build add-on security devices for legacy systems, while providing a path forward for the development of inherently-secure PCS elements in the future. Using standardized hardware, a proof-of-concept prototype system was also developed. This report describes the improvements and capabilities that have been added to OPSAID since an initial report was released. Testing and validation of this architecture has been conducted in another project, Lemnos Interoperable Security Project, sponsored by DOE/OE and managed by the National Energy Technology Laboratory (NETL).

  8. Atmospheric Release Advisory Capability (ARAC)

    International Nuclear Information System (INIS)

    Dickerson, M.H.

    1975-01-01

    The chief purpose of ARAC data acquisition program is to provide site officials, who are responsible for ensuring maximum health protection for the endangered site personnel and public, with estimates of the effects of atmospheric releases of hazardous material as rapidly and accurately as possible. ARAC is in the initial stages of being implemented and is therefore susceptible to changes before it reaches its final form. However the concept of ARAC is fully developed and was successfully demonstrated during a feasibility study conducted in June 1974, as a joint effort between the Savannah River Laboratory (SRL) and Lawrence Livermore Laboratory (LLL). Additional tests between SRL and LLL are scheduled for December 1975. While the immediate goal is the application of ARAC to assist a limited number of ERDA sites, the system is designed with sufficient flexibility to permit expanding the service to a large number of sites. Success in ARAC application should provide nuclear facilities with a means to handle better the urgent questions concerning the potential accidental hazards from atmospheric releases in addition to providing the sites with a capability to assess the effort of their normal operations

  9. Development of a gamma ray spectroscopy capability at LANSCE

    International Nuclear Information System (INIS)

    Nelson, R.O.; Strottman, D.D.; Sterbenz, S.M.

    1998-01-01

    This is the final report of a one-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The goal of this project was to explore an upgrade to the GEANIE high-resolution gamma-ray spectrometer at the Los Alamos Neutron Science Center (LANSCE) to help build additional experimental capabilities. The improvements identified have significantly added to the capabilities of GEANIE and made the facility more attractive for studies supporting the core national security mission as well as for use by outside collaborators. These benefits apply to both basic and applied studies

  10. Capabilities of infrared weld monitor

    Energy Technology Data Exchange (ETDEWEB)

    Sanders, P.G.; Keske, J.S.; Leong, K.H.; Kornecki, G.

    1997-11-01

    A non-obtrusive pre-aligned, solid-state device has been developed to monitor the primary infrared emissions during laser welding. The weld monitor output is a 100-1000 mV signal that depends on the beam power and weld characteristics. The DC level of this signal is related to weld penetration, while AC portions of the output can be correlated with surface irregularities and part misalignment or contamination. Changes in DC behavior are also noted for both full and deep penetration welds. Full penetration welds are signified by an abrupt reduction in the weld monitor output. Bead on plate welds were made on steel, aluminum, and magnesium with both a CW CO{sub 2} laser and a pulsed Nd:YAG laser to explore the relationships between the weld characteristics and the weld monitor output.

  11. Identifying challenges for academic leadership in medical universities in Iran.

    Science.gov (United States)

    Bikmoradi, Ali; Brommels, Mats; Shoghli, Alireza; Khorasani-Zavareh, Davoud; Masiello, Italo

    2010-05-01

    CONTEXT The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. OBJECTIVES This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. METHODS A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. RESULTS The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). CONCLUSIONS This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance.

  12. Extension of TRIGA reactor capabilities

    International Nuclear Information System (INIS)

    Gietzen, A.J.

    1980-01-01

    The first TRIGA reactor went into operation at 10 kW about 22 years ago. Since that time 55 TRIGAs have been put into operation including steady-state powers up to 14,000 kW and pulsing reactors that pulse to 20,000,000 kW. Five more are under construction and a proposal will soon be submitted for a reactor of 25,000 kW. Along with these increases in power levels (and the corresponding fluxes) the experimental facilities have also been expanded. In addition to the installation of new TRIGA reactors with enhanced capabilities many of the older reactors have been modified and upgraded. Also, a number of reactors originally fueled with plate fuel were converted to TRIGA fuel to take advantage of the improved technical and safety characteristics, including the ability for pulsed operation. In order to accommodate increased power and performance the fuel has undergone considerable evolution. Most of the changes have been in the geometry, enrichment and cladding material. However, more recently further development on the UZrH alloy has been carried out to extend the uranium content up to 45% by weight. This increased U content is necessary to allow the use of less than 20% enrichment in the higher powered reactors while maintaining longer core lifetime. The instrumentation and control system has undergone remarkable improvement as the electronics technology has evolved so rapidly in the last two decades. The information display and the circuitry logic has also undergone improvements for enhanced ease of operation and safety. (author)

  13. Medical Typewriting; Business Education: 7705.32.

    Science.gov (United States)

    Schull, Amy P.

    This guide describes a course designed to prepare students for employment as medical records clerks capable of handling all types of medical forms and reports, and using and spelling medical terminology correctly. The need for medical typists is critical. The guide contains enrollment guidelines, performance objectives (i.e., type medical…

  14. Under the veil of neoliberalism: inequality, health, and capabilities

    OpenAIRE

    Kemp, Eagan

    2008-01-01

    The relationship between income inequality and health has received substantial attention in the fields of medical sociology and public health and continues to be debated. In Chile, previous findings indicate that there is an income inequality effect; respondents who live in areas with high inequality experience a greater probability of poor self-reported health. This study examines the Wilkinson income inequality hypothesis in a new way by using it in conjunction with Sen’s capability approac...

  15. Indias Capabilities in Food Irradiation

    International Nuclear Information System (INIS)

    Ramesh, V.

    2005-09-01

    Full-text: India recently celebrated 50 years of nuclear application and criticality. Radiation processing Technology has been investigated and demonstrated for nearly four decades by food scientists and technologists at Bhabha Atomic Research Center, (BARC), India. It is quite essential to clarify unambiguously that under no circumstances can radiation processing using cobalt-60 radiation induce any radioactivity and naturally, leave residual radioactivity in the material being processed. To this extent, the word IRRADIATION has been replaced by the word Radiation Processing. The Indian Navy had recently approved the use of radiation processing for preserving high value food products and to optimize the procurement cost and maximize the product availability. The Board of Radiation and Isotope Technology (BRIT), India has achieved significant milestones in encouraging private entrepreneurs to set up Radiation Processing plants for food preservation and safety as well as for non-food products and medical equipment sterilization. Today there are about 25 private radiation processing plants getting ready to meet the demand and many more are following the trend. With the growing demand for Cobalt-60 source, India has exported the technology and the source to many neighboring countries and is prepared to meet the demand and support the requirements of the Cobalt-60 source in Thailand. Innovative Food Technologies Co. Ltd provide consultancy and turnkey projects to set up Radiation processing Plants, Supply of Cobalt-60 source, Refurbishing Cobalt-60 source, provide comprehensive training in Plant safety, maintenance and security in Thailand and ASEAN

  16. Abdominal exploration

    Science.gov (United States)

    ... help diagnose and treat many health conditions, including: Cancer of the ovary, colon, pancreas, liver Endometriosis Gallstones Hole in the intestine (intestinal perforation) Inflammation of the appendix ( acute ... practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed ...

  17. Farside explorer

    DEFF Research Database (Denmark)

    Mimoun, David; Wieczorek, Mark A.; Alkalai, Leon

    2012-01-01

    the primary differentiation and evolution of the Moon, it can be continuously monitored from the Earth-Moon L2 Lagrange point, and there is a complete lack of reflected solar illumination from the Earth. Farside Explorer will exploit these properties and make the first radio-astronomy measurements from...... the most radio-quiet region of near-Earth space, determine the internal structure and thermal evolution of the Moon, from crust to core, and quantify impact hazards in near-Earth space by the measurement of flashes generated by impact events. The Farside Explorer flight system includes two identical solar......Farside Explorer is a proposed Cosmic Vision medium-size mission to the farside of the Moon consisting of two landers and an instrumented relay satellite. The farside of the Moon is a unique scientific platform in that it is shielded from terrestrial radio-frequency interference, it recorded...

  18. Uranium exploration

    International Nuclear Information System (INIS)

    De Voto, R.H.

    1984-01-01

    This paper is a review of the methodology and technology that are currently being used in varying degrees in uranium exploration activities worldwide. Since uranium is ubiquitous and occurs in trace amounts (0.2 to 5 ppm) in virtually all rocks of the crust of the earth, exploration for uranium is essentially the search of geologic environments in which geologic processes have produced unusual concentrations of uranium. Since the level of concentration of uranium of economic interest is dependent on the present and future price of uranium, it is appropriate here to review briefly the economic realities of uranium-fueled power generation. (author)

  19. Performance Support Tools for Space Medical Operations

    Science.gov (United States)

    Byrne, Vicky E.; Schmidt, Josef; Barshi, Immanuel

    2009-01-01

    The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Human factors personnel at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground. This area of research involved the feasibility of Just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction were captured. Information needed by the FS during ISS mission support, especially for an emergency situation (e.g. fire onboard ISS), may be located in many different places around the FS s console. A performance support tool prototype is being developed to address this issue by bringing all of the relevant information together in one place. The tool is designed to include procedures and other information needed by a FS

  20. Array capabilities and future arrays

    International Nuclear Information System (INIS)

    Radford, D.

    1993-01-01

    Early results from the new third-generation instruments GAMMASPHERE and EUROGAM are confirming the expectation that such arrays will have a revolutionary effect on the field of high-spin nuclear structure. When completed, GAMMASHPERE will have a resolving power am order of magnitude greater that of the best second-generation arrays. When combined with other instruments such as particle-detector arrays and fragment mass analysers, the capabilites of the arrays for the study of more exotic nuclei will be further enhanced. In order to better understand the limitations of these instruments, and to design improved future detector systems, it is important to have some intelligible and reliable calculation for the relative resolving power of different instrument designs. The derivation of such a figure of merit will be briefly presented, and the relative sensitivities of arrays currently proposed or under construction presented. The design of TRIGAM, a new third-generation array proposed for Chalk River, will also be discussed. It is instructive to consider how far arrays of Compton-suppressed Ge detectors could be taken. For example, it will be shown that an idealised open-quote perfectclose quotes third-generation array of 1000 detectors has a sensitivity an order of magnitude higher again than that of GAMMASPHERE. Less conventional options for new arrays will also be explored

  1. Global dynamics, capabilities and the crisis

    Czech Academy of Sciences Publication Activity Database

    Fagerberg, J.; Srholec, Martin

    2016-01-01

    Roč. 26, č. 4 (2016), s. 765-784 ISSN 0936-9937 Institutional support: PRVOUK-P23 Keywords : technological capabilities * social capabilities * competitiveness Subject RIV: AH - Economics Impact factor: 0.862, year: 2016

  2. Liberalism, Humanism, and Feminism in Nussbaum's Capabilities ...

    African Journals Online (AJOL)

    A purely theoretical analysis of Martha Nussbaum's basis of the capabilities ... Since even a capabilities approach rooted in feminist justice is itself radical and must ... rhetoric of sex and social justice that has already been embraced by current

  3. Sandia Laboratories technical capabilities: systems analysis

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-06-01

    The systems analysis capabilities at Sandia Laboratories are summarized. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs. (U.S.)

  4. Sandia Laboratories technical capabilities: engineering analysis

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-12-01

    This report characterizes the engineering analysis capabilities at Sandia Laboratories. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  5. DDP-516 Computer Graphics System Capabilities

    Science.gov (United States)

    1972-06-01

    This report describes the capabilities of the DDP-516 Computer Graphics System. One objective of this report is to acquaint DOT management and project planners with the system's current capabilities, applications hardware and software. The Appendix i...

  6. AMBIDEXTER Dynamics and Self-Regulation Capability

    International Nuclear Information System (INIS)

    Oh, Se Kee; Lee, Young Joon; Ham, Tae Kyu; Seo, Myung Hwan; Hong, Sung Taek; Kwon, Tae An

    2009-01-01

    Safety-related events in a nuclear reactor system are mostly incurred by sudden imbalance between their heat source and sink behaviors. Controllability and resiliency are assessed if the system be safely recoverable from the imbalance. Inherent safety characteristics of the reactor should be an ideal design philosophy in this aspect. The AMBIDEXTER safety design was explored with maximum reliance on counteractive responses by the system itself. As for the realization, negative reactivity feedback and fail-safe criteria are the fundamental considerations. Details of how to implement them in the design can be found in the paper accompanied. the reactor and the primary heat exchanger are integrated into a closed loop in the vessel. The fuel salt flows downwardly in the outer core region, gains fission heat and then, rises upwardly through the central inner core region where resonance absorbers face better conversion chance. In the primary heat exchanger, heat transfer between the tube-side fuel salt and the shell-side coolant salt is made. For chemical processing, part of the fuel salt flow is discharged from the heat exchanger and returns to the reactor through bypass line. This paper examines the dynamic performances of the AMBIDEXTER reactor system to investigate the range of its self-regulation capability and safety impacts

  7. Towards a National Space Weather Predictive Capability

    Science.gov (United States)

    Fox, N. J.; Ryschkewitsch, M. G.; Merkin, V. G.; Stephens, G. K.; Gjerloev, J. W.; Barnes, R. J.; Anderson, B. J.; Paxton, L. J.; Ukhorskiy, A. Y.; Kelly, M. A.; Berger, T. E.; Bonadonna, L. C. M. F.; Hesse, M.; Sharma, S.

    2015-12-01

    National needs in the area of space weather informational and predictive tools are growing rapidly. Adverse conditions in the space environment can cause disruption of satellite operations, communications, navigation, and electric power distribution grids, leading to a variety of socio-economic losses and impacts on our security. Future space exploration and most modern human endeavors will require major advances in physical understanding and improved transition of space research to operations. At present, only a small fraction of the latest research and development results from NASA, NOAA, NSF and DoD investments are being used to improve space weather forecasting and to develop operational tools. The power of modern research and space weather model development needs to be better utilized to enable comprehensive, timely, and accurate operational space weather tools. The mere production of space weather information is not sufficient to address the needs of those who are affected by space weather. A coordinated effort is required to support research-to-applications transition efforts and to develop the tools required those who rely on this information. In this presentation we will review the space weather system developed for the Van Allen Probes mission, together with other datasets, tools and models that have resulted from research by scientists at JHU/APL. We will look at how these, and results from future missions such as Solar Probe Plus, could be applied to support space weather applications in coordination with other community assets and capabilities.

  8. Heavy Lift Launch Capability with a New Hydrocarbon Engine (NHE)

    Science.gov (United States)

    Threet, Grady E., Jr.; Holt, James B.; Philips, Alan D.; Garcia, Jessica A.

    2011-01-01

    The Advanced Concepts Office (ACO) at NASA Marshall Space Flight Center has analyzed over 2000 Ares V and other heavy lift concepts in the last 3 years. These concepts were analyzed for Lunar Exploration Missions, heavy lift capability to Low Earth Orbit (LEO) as well as exploratory missions to other near earth objects in our solar system. With the pending retirement of the Shuttle fleet, our nation will be without a civil heavy lift launch capability, so the future development of a new heavy lift capability is imperative for the exploration and large science missions our Agency has been tasked to deliver. The majority of the heavy lift concepts analyzed by ACO during the last 3 years have been based on liquid oxygen / liquid hydrogen (LOX/LH2) core stage and solids booster stage propulsion technologies (Ares V / Shuttle Derived and their variants). These concepts were driven by the decisions made from the results of the Exploration Systems Architecture Study (ESAS), which in turn, led to the Ares V launch vehicle that has been baselined in the Constellation Program. Now that the decision has been made at the Agency level to cancel Constellation, other propulsion options such as liquid hydrocarbon fuels are back in the exploration trade space. NASA is still planning exploration missions with the eventual destination of Mars and a new heavy lift launch vehicle is still required and will serve as the centerpiece of our nation s next exploration architecture s infrastructure. With an extensive launch vehicle database already developed on LOX/LH2 based heavy lift launch vehicles, ACO initiated a study to look at using a new high thrust (> 1.0 Mlb vacuum thrust) hydrocarbon engine as the primary main stage propulsion in such a launch vehicle.

  9. Towards a dynamic concept of alliance capability

    OpenAIRE

    SLUYTS, Kim; MARTENS, Rudy; MATTHYSSENS, Paul

    2008-01-01

    This paper has a threefold purpose. First, we offer a literature review on alliance capability based on strategic and competence based management literature. Second, we extend existing literature on alliance capability by breaking this concept down into five sub capabilities, which are each linked to a stage of the alliance life cycle. Finally, we suggest how firms can support these capabilities through structural, technological and people-related tools and techniques. We argue that current l...

  10. College Explorer.

    Science.gov (United States)

    Ahl, David H.

    1985-01-01

    The "College Explorer" is a software package (for the 64K Apple II, IBM PC, TRS-80 model III and 4 microcomputers) which aids in choosing a college. The major features of this package (manufactured by The College Board) are described and evaluated. Sample input/output is included. (JN)

  11. Exploring Size.

    Science.gov (United States)

    Brand, Judith, Ed.

    1995-01-01

    "Exploring" is a magazine of science, art, and human perception that communicates ideas museum exhibits cannot demonstrate easily by using experiments and activities for the classroom. This issue concentrates on size, examining it from a variety of viewpoints. The focus allows students to investigate and discuss interconnections among…

  12. Combining Land Capability Evaluation, Geographic Information ...

    African Journals Online (AJOL)

    Combining Land Capability Evaluation, Geographic Information Systems, AnD Indigenous Technologies for Soil Conservation in Northern Ethiopia. ... Land capability and land use status were established following the procedures of a modified treatment-oriented capability classification using GIS. The case study ...

  13. Organisational Capability--What Does It Mean?

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2006

    2006-01-01

    Organisational capability is rapidly becoming recognized as the key to organizational success. However, the lack of research on it has been well documented in the literature, and organizational capability remains an elusive concept. Yet an understanding of organizational capability can offer insights into how RTOs might work most effectively,…

  14. Selecting Capabilities for Quality of Life Measurement

    Science.gov (United States)

    Robeyns, Ingrid

    2005-01-01

    The capability approach advocates that interpersonal comparisons be made in the space of functionings and capabilities. However, Amartya Sen has not specified which capabilities should be selected as the relevant ones. This has provoked two types of criticism. The stronger critique is Martha Nussbaum's claim that Sen should endorse one specific…

  15. Exploring digital professionalism.

    Science.gov (United States)

    Ellaway, Rachel H; Coral, Janet; Topps, David; Topps, Maureen

    2015-01-01

    The widespread use of digital media (both computing devices and the services they access) has blurred the boundaries between our personal and professional lives. Contemporary students are the last to remember a time before the widespread use of the Internet and they will be the first to practice in a largely e-health environment. This article explores concepts of digital professionalism and their place in contemporary medical education, and proposes a series of principles of digital professionalism to guide teaching, learning and practice in the healthcare professions. Despite the many risks and fears surrounding their use, digital media are not an intrinsic threat to medical professionalism. Professionals should maintain the capacity for deliberate, ethical, and accountable practice when using digital media. The authors describe a digital professionalism framework structured around concepts of proficiency, reputation, and responsibility. Digital professionalism can be integrated into medical education using strategies based on awareness, alignment, assessment, and accountability. These principles of digital professionalism provide a way for medical students and medical practitioners to embrace the positive aspects of digital media use while being mindful and deliberate in its use to avoid or minimize any negative consequences.

  16. National power grid simulation capability : need and issues

    Energy Technology Data Exchange (ETDEWEB)

    Petri, Mark C. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2009-06-02

    On December 9 and 10, 2008, the Department of Homeland Security (DHS) Science and Technology Directorate sponsored a national workshop at Argonne National Laboratory to explore the need for a comprehensive modeling and simulation capability for the national electric power grid system. The workshop brought together leading electric power grid experts from federal agencies, the national laboratories, and academia to discuss the current state of power grid science and engineering and to assess if important challenges are being met. The workshop helped delineate gaps between grid needs and current capabilities and identify issues that must be addressed if a solution is to be implemented. This report is a result of the workshop and highlights power grid modeling and simulation needs, the barriers that must be overcome to address them, and the benefits of a national power grid simulation capability.

  17. An Evidence Based Approach to Designing Medical Support for Long Duration, Interplanetary Missions

    Science.gov (United States)

    Watkins, S. D.; McGrath, T. L.; Bauman, D. K.; Wu, J. H.; Barsten, K. N.; Barr, Y. R.; Kerstman, E. L.

    2011-01-01

    The Exploration Medical Capability (ExMC) element is one of six elements under NASA's Human Research Program (HRP). The goal of the ExMC element is to address the risk of the "inability to adequately recognize or treat an ill or injured crewmember." This poster highlights the evidence-based approach that the ExMC element has taken to address this goal, and the ExMC element's current areas of interest.

  18. Cannabinoids: Medical implications.

    Science.gov (United States)

    Schrot, Richard J; Hubbard, John R

    2016-01-01

    Herbal cannabis has been used for thousands of years for medical purposes. With elucidation of the chemical structures of tetrahydrocannabinol (THC) and cannabidiol (CBD) and with discovery of the human endocannabinoid system, the medical usefulness of cannabinoids has been more intensively explored. While more randomized clinical trials are needed for some medical conditions, other medical disorders, like chronic cancer and neuropathic pain and certain symptoms of multiple sclerosis, have substantial evidence supporting cannabinoid efficacy. While herbal cannabis has not met rigorous FDA standards for medical approval, specific well-characterized cannabinoids have met those standards. Where medical cannabis is legal, patients typically see a physician who "certifies" that a benefit may result. Physicians must consider important patient selection criteria such as failure of standard medical treatment for a debilitating medical disorder. Medical cannabis patients must be informed about potential adverse effects, such as acute impairment of memory, coordination and judgment, and possible chronic effects, such as cannabis use disorder, cognitive impairment, and chronic bronchitis. In addition, social dysfunction may result at work/school, and there is increased possibility of motor vehicle accidents. Novel ways to manipulate the endocannbinoid system are being explored to maximize benefits of cannabinoid therapy and lessen possible harmful effects.

  19. The Application of LENR to Synergistic Mission Capabilities

    Science.gov (United States)

    Wells, Douglas P.; Mavris, Dimitri N.

    2014-01-01

    This paper presents an overview of several missions that exploit the capabilities of a Low Energy Nuclear Reaction (LENR) aircraft propulsion system. LENR is a form of nuclear energy and potentially has over 4,000 times the energy density of chemical energy sources. It does not have any harmful emissions or radiation which makes it extremely appealing. The global reliance on crude oil for aircraft energy creates the opportunity for a revolutionary change with LENR. LENR will impact aircraft performance capabilities, military capabilities, the environment, the economy, and society. Although there is a lot of interest in LENR, there is no proven theory that explains it. Some of the technical challenges are thermal runaway and start-up time. This paper does not explore the feasibility of LENR and assumes that a system is available. A non-dimensional aircraft mass (NAM) ratio diagram is used to explore the aircraft system design space. The NAM ratio diagram shows that LENR can enable long range and high speed missions. The design space exploration led to the conclusion that LENR aircraft would be well suited for high altitude long endurance (HALE) missions, including communications relay and scientific missions for hurricane tracking and other weather phenomena, military intelligence, surveillance, and reconnaissance (ISR) and airspace denial missions, supersonic passenger transport aircraft, and international cargo transport. This paper describes six of those missions.

  20. Distinctive Dynamic Capabilities for New Business Creation

    DEFF Research Database (Denmark)

    Rosenø, Axel; Enkel, Ellen; Mezger, Florian

    2013-01-01

    This study examines the distinctive dynamic capabilities for new business creation in established companies. We argue that these are very different from those for managing incremental innovation within a company's core business. We also propose that such capabilities are needed in both slow...... and fast-paced industries, and that similarities exist across industries. Hence, the study contributes to dynamic capabilities literature by: 1) identifying the distinctive dynamic capabilities for new business creation; 2) shifting focus away from dynamic capabilities in environments characterised by high...... clock-speed and uncertainty towards considering dynamic capabilities for the purpose of developing new businesses, which also implies a high degree of uncertainty. Based on interviews with 33 companies, we identify distinctive dynamic capabilities for new business creation, find that dynamic...